Magnetic resonance imaging features in the tubercular spine: A cross sectional study from North India

Introduction: Spinal TB (Pott’s disease) is the most common, as well as one of the most potentially dangerous forms of skeletal TB, with an incidence of neurological complications as high as 10% to 43%. Radiographic manifestations of tuberculous spondylitis include intraosseous and paraspinal abscess formation, subligamentous spread of infection, vertebral body destruction and collapse, and extension into the spinal epidural space. Catastrophic neurological sequelae can lead to mortality and significant chronic morbidity. Early diagnosis and timely initiation of treatment can be a boon to such patients.
Objective: This retrospective cross-sectional study was conducted to identify common patterns of tubercular spinal osteomyelitis on MRI.
Materials and Methods: The current study is a cross-sectional observational study conducted by reviewing existing MRI images in the radiology department. The MRI spine studies of subsequently proven cases of spinal TB were included in the study. These images were re-evaluated and compiled by experienced radiologists.
Results: The thoracic spine was the most common site of involvement. Vertebral body wedge collapse or compression fracture was seen in 64% of patients. Posterior element involvement was found in 10 out of 20 cases. Prevertebral and paravertebral collections were seen in 65% of cases. Spinal cord compression was seen in 55% of cases.
Conclusion: MRI is an excellent imaging modality for spinal tuberculosis due to its ability to pick up early as well as advanced changes of the disease and provide the best possible anatomic demarcation of the extent of the disease.