Anatomic basis for the pathogenesis and radiologic features of vertebral osteomyelitis and its differentiation from childhood discitis. A microarteriographic investigation.
Microarteriography has demonstrated the anatomy which explains the pathogenesis and radiologic features of adult vertebral osteomyelitis and of childhood discitis. Infarction is caused in the metaphysis by a septic embolus. The intraosseous arteries in children are anastomotic and a small portion of bone is destroyed. In adults a larger portion of bone is destroyed because the intraosseous arteries are end-arteries and septic thrombosis spreads into peripheral intraosseous arteries. The disc is avascular at all ages and is attacked by infection equally. The trans-equatorial spread of osteomyelitis occurs via an artery which is first described here. It joins the metaphyseal anastomoses of the same vertebral body in the midline.
D000328:Adult; D000792:Angiography / Q000379:methods; D001158:Arteries / Q000033:anatomy & histology; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010000:Osteitis / Q000000981:diagnostic imaging / Q000473:pathology; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000473:pathology; D010521:Periosteum / Q000033:anatomy & histology / Q000098:blood supply; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology