Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection-A Case Series of 135 Patients with Spontaneous Spondylodiscitis.
Friederike SchömigZhao LiLuis BeckerTu-Lan Vu-HanMatthias PumbergerTorsten DiekhoffPublished in: Diagnostics (Basel, Switzerland) (2022)
Gas in the intervertebral disc is mainly associated with degenerative disc diseases and experts generally assume that it is unlikely in spinal infection. However, large-scale studies supporting this notion are lacking, which is why our study's aim was to analyze the prevalence of and factors associated with the occurrence of gas in patients with spontaneous spondylodiscitis. Patients presenting with spontaneous spondylodiscitis from 2006 to 2020 were included retrospectively. Exclusion criteria were previous interventions in the same spinal segment and missing imaging data. Clinical data were retrieved from electronic medical reports. Computed tomography (CT) scans were evaluated for the presence of intervertebral gas. Causative pathogens were identified from CT-guided biopsy, open biopsy, intraoperative tissue samples, and/or blood cultures. 135 patients with a mean age of 66.0 ± 13.7 years were included. In 93 patients (68.9%), a causative pathogen was found. Intervertebral gas was found in 31 patients (23.0%) in total and in 19 patients (20.4%) with positive microbiology. Patients with gas presented with significantly higher body temperatures (37.2 ± 1.1 vs. 36.8 ± 0.7 °C, p = 0.044) and CRP levels (134.2 ± 127.1 vs. 89.8 ± 97.3 mg/L, p = 0.040) on admission. As a considerable number of patients with spondylodiscitis showed intervertebral gas formation, the detection of intervertebral gas is not suited to ruling out spondylodiscitis but must be interpreted in the context of other imaging and clinical findings, especially in elderly patients.
Keyphrases
- computed tomography
- room temperature
- end stage renal disease
- carbon dioxide
- newly diagnosed
- spinal cord
- ejection fraction
- chronic kidney disease
- contrast enhanced
- magnetic resonance imaging
- high resolution
- positron emission tomography
- image quality
- risk assessment
- ultrasound guided
- magnetic resonance
- minimally invasive
- patients undergoing
- electronic health record
- machine learning
- mass spectrometry
- spinal cord injury
- data analysis
- quantum dots