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At least 1,189 records · Page 66Linked to original sources
PubMed1995

Differentiation of vertebral osteomyelitis and tuberculous spondylitis by magnetic resonance imaging.

Twenty patients with vertebral osteomyelitis and 18 with tuberculous spondylitis were investigated by magnetic resonance imaging to identify the distinguishing features. The number of vertebral bodies involved was less in vertebral osteomyelitis than in tuberculous spondylitis, and the paravertebral abscesses were smaller. The magnetic resonance intensity of the involved vertebral bodies was more homogeneous in vertebral osteomyelitis than in tuberculous spondylitis. Rim enhancement with Gadolinium-DTPA was less frequent in vertebral osteomyelitis. The differentiation of the two conditions by MRI was helpful in establishing the correct diagnosis of the infection.

Adult↗
PubMed2006

[Spinal infections].

Regardless of the compartment involved, imaging of spinal infections and other spinal inflammatory diseases must be performed by magnetic resonance imaging (MRI). This allows early detection of changes in disk space or vertebral bodies. Associated paraspinal and epidural masses are depicted. However, in spinal cord inflammation MRI has a very limited specificity and cannot usually differentiate between the wide array of possible causes of intramedullary lesions. This article covers a spectrum of inflammatory lesions of the spinal cord.

Adult↗
PubMed1994

Intramedullary spinal tuberculomas during treatment of tuberculous meningitis.

A case of multiple intramedullary spinal tuberculomas developing paradoxically during effective treatment of tuberculous meningitis is described. Serial MR imagings with Gd-DTPA enhancement studies showed initial homogeneous enhanced lesion representing myelitis or the early tuberculoma stage, which evolved to show ring enhancement with hypointense center later. Their appearance was similar to those described in brain tuberculoma. Gd-DTPA enhancement MR imaging is more sensitive than MR imaging without enhancement in demonstrating the lesions of tuberculoma and arachnoiditis. Antituberculous medication was effective with marked clinical improvement.

Adult↗
PubMed2000

Late onset Pott's paraplegia.

BACKGROUND: Pott's disease may cause late neurological involvement due to development of sharp kyphosis. Anterior decompression and fusion is the treatment of choice for this disorder. OBJECTIVE: To determine the mid-term clinical results of patients with late onset Pott's paraplegia, who underwent anterior decompression and grafting after neurological deterioration. SETTING: A university hospital in Istanbul, Turkey. METHODS: Eight patients who developed late onset paraplegia with a mean period of 24.6 years (range, 9-46 years) after the active disease were treated with anterior decompression and grafting. The mean age at surgery was 36.1 years (range, 18-63 years) and the mean duration of neurological deterioration before surgery was 7.4 weeks (range, 2-13 weeks). The mean kyphosis angle of the patients was 105.63 degrees (range, 80 degrees- 135 degrees). No attempt to correct the curve was made in any operation. All but two patients' neurological status were evaluated according to the International Standards for Neurological and Functional Classification of Spinal Cord Injury determined by ASIA-IMSOP on admission. RESULTS: Neurological status of all patients showed progression either in Frankel scale or in motor scores in the early postoperative period. One patient needed to be reoperated on because of a deterioration of neurological status 26 months after surgery. The mean length of time since the operations is 75.9 months (range, 48 173 months) and all the patients are carrying out their lives independently with a mean motor score of 97.5 and full pin-prick and light touch scores. CONCLUSIONS: Anterior decompression and grafting is an effective procedure for the treatment of late onset paraplegia in Pott's disease.

Adolescent↗
PubMed1978

[Selective spinal arteriography in vertebral and paravertebral disease processes (author's transl)].

Selective arteriography was performed on 15 patients with vertebral and paravertebral diseases. This procedure is particularly justified if the bone changes are of possible vascular origin, if the presence of arterial involvement by neoplasm is to be determined, or if one wishes to judge the extent of intraspinal or paravertebral spread of a spinal tumour. Up to a point, angiography may indicate the histology and malignancy of a mass. In the diagnosis of vertebral and paravertebral disease, selective spinal arteriography would come into competition with computed tomography. Either procedure should only be used if conventional methods are incapable of solving the diagnostic problem.

Adult↗
PubMed2003

[Intramedullary abscess of the spinal cord--a rare pathology. Case report, therapeutic regimen and review of the literature].

Although the presence of an intramedullary abscess of the spinal cord is extremely rare, it is most important to be aware of its existence in the differential diagnosis of neurological diseases. Existing neurological deficits with progressive symptoms of paraplegia should always be regarded as suspect and a differential diagnosis of an intramedullary abscess of the spinal cord should then be included in the therapeutical regimen. A correct diagnosis using MR-tomography followed by an early surgical treatment strategy are essential for the affected patients, simply because an early diagnosis and an immediate operative intervention represent decisive prognostic factors independent from the cause of infection. Surgical intervention must include a decompressive laminectomy, a myelotomy, and also a secure intraoperative abscess drainage. In this analysis two patients will be reported on, both of whom were already showing symptoms of paraplegia at the time they were admitted to hospital. In both cases MR-tomographically an intramedullary nodulary lesion of the spinal cord could be detected. However, due to a complete lack of any acute symptoms of inflammatory reaction in one patient, an intramedullary abscess was not actually diagnosed before surgical treatment was performed. These two cases, together with existing scientific literature, aim to present an overview of the pathogenesis, the clinical symptomatology, the treatment strategy, and the expected therapeutical outcome of an intramedullary abscess formation. It will be shown that by treating this disease as early as possible using adequate therapeutic interventions a functional improvement of the resulting neurological symptoms can be expected.

Abscess↗
PubMedDate not supplied

[Differentiated surgical and conservative treatment of spondylitis and spondylodiscitis].

In the time from 1980 to 1987 58 patients underwent a conservative or operative treatment of spondylitis and spondylodiscitis according to the individual clinical and radiological features. In early or moderately advanced stages of the disease conservative therapy was performed. Under bedrest and antibacterial or tuberculostatic drug therapy bony fusion of the affected vertebral bodies was achieved in 50% of the pyogenic cases. In tuberculous spondylitis fusion rate was 83%. Persistent septic changes, progressive neurological symptoms and gross vertebral damage are indications for surgery. In those cases removal of the focus and intercorporal spondylodesis was performed. Bony union occurred in every cases. At follow-up examination, 3 years after the onset of therapy on an average, 42 patients had no complaints according to the vertebral column. As the results of our study show spondylitis and spondylodiscitis should according to the clinical and radiological features be lead to a differentiated operative or conservative treatment. Then good clinical results are to be supposed.

Adolescent↗
PubMed1993

Extraosseous epidural tuberculoma: case report and review.

Extraosseous epidural tuberculoma has been reported infrequently, in spite of the widespread availability in recent years of computerized axial tomography and magnetic resonance imaging that can detect bony involvement not apparent on roentgenography with plain films. Thirty-two cases of extraosseous epidural tuberculoma have been reported in the English-language literature; however, only seven of these were radiologically and microbiologically confirmed. The single case from North America was reported over 30 years ago. We describe a patient with a spinal epidural mass due to Mycobacterium tuberculosis that was not associated with bony involvement and review the epidemiology, pathophysiology, presentation, and outcome of the previously reported cases.

Adult↗
PubMedDate not supplied

Apophyseal joint degeneration in the cervical spine following halo-pelvic distraction.

A review of the roentgenograms and clinical findings of 100 patients seen consecutively who had had halo-pelvic distraction for the correction of spinal deformity showed an overall incidence of cases with apophyseal joint degeneration of 47.4%. There were independent and significant differences between the asymptomatic and symptomatic groups with regard to patients' ages and the amounts of the time spent in halo-pelvic distraction. Stepwise discriminant analysis has yielded a table of the maximum amount of time a patient can spend in halo-pelvic traction per year of age, beyond which there is a significant chance of developing degenerative changes.

Adolescent↗