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SYMPOSIUM – POST SURGICAL SPINE INFECTION
Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 7-16

Imaging of postoperative spinal infections


1 Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
2 Department of Spine surgery, Uday Omni Hospitals & Apollo Health City, Hyderabad, Telangana, India
3 Department of Radiodiagnosis, Armed Forces medical college, Pune, Maharashtra, India

Correspondence Address:
Dr. Vadapalli Sai VenkataRammohan
Krishna Institute of Medical Sciences, Secunderabad, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/isj.isj_27_17

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The spectrum of postoperative spinal infections includes superficial and deep infections, wound infections, spondylodiscitis, intraspinal epidural abscess, infective arachnoiditis, the extraspinal pre- and paravertebral extension of intraspinal abscesses, and necrotic collections. Imaging modalities for detection of these pathologies include plain radiographs, multidetector computed tomography, magnetic resonance imaging (MRI), and radionucleotide scintigraphy. MRI allows adequate visualization of both the bony structures and soft tissues. Contrast enhanced MRI with gadolinium is the imaging modality of choice to delineate postprocedural and postoperative spine infections and complications. MRI has high sensitivity and specificity in the diagnosis of postoperative spondylodiscitis, epidural abscesses, and infective arachnoiditis. Metallic orthopedic hardware may produce artifacts that degrade image quality which is resolved by a metal artifacts reduction sequence to optimize the image quality in bone and soft tissues. F-18 fluorodeoxyglucose positron-emitted tomography is superior to MRI not only in patients with surgical history and high grade infection but also in the patient with low grade spondylodiscitis.


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