31 March 2024: Review Articles
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future Applications
Weijian Zhu 12BCEF , Sirui Zhou 3D , Jinming Zhang 1D , Li Li 4B , Pin Liu 2A , Wei Xiong 1A*DOI: 10.12659/MSM.943168
Med Sci Monit 2024; 30:e943168
Introduction
Segmental Structure of the Spine
Diagnostic Value of Plain Radiographs and Computed Tomography for NVO
Diagnostic Value of MRI in NVO
Pyogenic Spondylitis
Tuberculous Spondylitis
Brucellar Spondylitis
Fungal Spondylitis
Diagnostic Value of Positron Emission Tomography for NVO
Artificial Intelligence Applications and the Future
Conclusions
References
Table 1 Plain radiograph and computed tomography imaging characteristics of native vertebral osteomyelitis.
| Author | Year | Sample size | Disease conditions | Purpose | Results |
|---|---|---|---|---|---|
| Liu et al []15 | 2020 | 76 | 10 weeks for PS group and 18 weeks for BS group | Comparison of CT imaging features of PS and BS | Vertebral destruction is more extensive in PS and less so in BS. The bone destruction in BS was surrounded by more osteosclerosis, including osteosclerotic encircling foci and scalloped osteosclerosis. There was more bone formation around the vertebral body (especially below the anterior longitudinal ligament) in BS than in PS |
| Liu et al []16 | 2021 | 112 | 2.1 months in the PS group and 6.8 months in the BS group | Identify the CT imaging features of TS and PS and develop a discriminatory model | Patients with PS exhibit less bone destruction, which is usually confined to specific areas of the vertebral body and wall. On the other hand, patients with TS tend to have more widespread bone destruction that affects multiple vertebrae, often resulting in longitudinal destruction of the vertebral body. Patients with PS also show fewer instances of perivertebral bone formation, while patients with TS often present significant perivertebral bone formation. The morphology of the vertebral body in patients with PS is typically more regular and shows no apparent abnormalities. However, patients with TS may have a vertebral body morphology that exhibits depression, invagination, or rectangular disruption. Patients with PS also tend to have less bone necrosis, usually with only pitting. In contrast, in patients with TS, bone necrosis is more extensive, often showing frame shaped osteosclerosis |
| Koubaa et al []49 | 2013 | 32 | Average age 51±15 years/The median is 90 days | Evaluate the clinical, laboratory, and imaging manifestations and outcomes of brucellosis involving the vertebral body | Plain radiograph: localized erosion of the vertebral bodies is characteristic of BS. Anterior or diffuse disc collapse is very common. Bone destruction is milder than in TS. Typical periosteal bone formation and bone redundancy at the anterior end of the vertebral body are characteristic of BS. CT can show that the involved discs show small areas of hypodensity, disc flattening and vertebral endplate destruction that are not visible on early conventional plain radiograph. CT can also define the extent of the inflammatory process. Paravertebral abscesses with psoas major muscle involvement can be easily diagnosed after contrast injection |
| CT – computed tomography; TS – tuberculous spondylitis; BS – brucellar spondylitis; PS – pyogenic spondylitis; TS – tuberculous spondylitis; BS – brucellar spondylitis. | |||||