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    Module

    MRI Lumbar Spine

    The basic principles of the MRI scan of the lumbar spine.

    MRI Lumbar Spine
    Radiology Expert
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    Pathology - Spondylodiscitis 

    In spondylodiscitis (also known as 'vertebral osteomyelitis'), there is an infection of the intervertebral disc and the adjacent vertebral bodies. Contrary to the name, the infection begins in the vertebral endplate and then spreads into the (avascular) disc. Spondylodiscitis can occur at any spinal level but is most commonly seen in the lumbar spine, followed by the cervical and thoracic spine.
    In most cases, there is a secondary infection originating from an inflammatory process elsewhere in the body (hematologic spread), especially from the urogenital system. Pneumonia, endocarditis, and inflammation in the ENT area can also be sources of infection. A less common cause (20% - 30%) of spondylodiscitis is direct contamination due to invasive spinal procedures; postoperative spondylodiscitis. The most common causative agent is Staphylococcus aureus. Other relatively common causative agents include Pseudomonas aeruginosa (in intravenous drug users) and mycobacteria (in immunocompromised patients).

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    Literature: sources and author

    Text

    drs. A. van der Plas (MSK radiologist Maastricht UMC+)

    With special thanks to:
    dr. W. Henneman (neuroradiologist Maastricht UMC+)

    Illustrations

    drs. A. van der Plas (MSK radiologist Maastricht UMC+)


    Sources:

    • C. Lavy, P. Marks, K. Dangas, N. Todd; Cauda equina syndrome—a practical guide to definition and classification. International Orthopaedics (2022)

    • L. Bulloch, K. Thompson, L. Spector; Cauda Equina Syndrome. Orthop Clin North Am. (2022)

    • C. Colosimo et al; Contrast-enhanced MR imaging of the spine: When, why and how? How to optimize contrast protocols in MR imaging of the spine. Neuroradiology (2006)

    • M. Farshad et al; Spondylophyte classification based on biomechanical effects on segmental stiffness. Spine J (2022)
      T.S. Jensen et al.; Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J. (2008)

    • A. Pietrok; Schmorl’s Node: An Uncommon Case of Back Pain and Radiculopathy. Orthop Rev (Pavia). 2022

    • A.C Gellhorn, J.N Katz, P. Suri; Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol (2013)

    • D.F. Fardon et al; Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J (2014)

    • S. Boudabbous et al; Spinal disorders mimicking infection. Insights into Imaging (2021)

    • J. Lotz; The Role of the Vertebral End Plate in Low Back Pain. Global Spine Journal (2013)

    • J.S. Kim et.al; Clinical Significance of Redundant Nerve Roots of the Cauda Equina in Spine MRI. iMRI (2022)

    • L. Cottle, T. Riordan; Infectious spondylodiscitis. J Infec (2008) 

    • H.P. Ledermann et.al; MR imaging findings in spinal infections: rules or myths? Radiology (2003)

       

    08/10/2023

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