title: The role of magnetic resonance imaging in the diagnosis of postoperative spondylodiscitis.
abstract: BACKGROUND
  Spondylodiscitis, discitis associated with vertebral osteomyelitis may follow disc-removal surgery. A targeted successful treatment of spinal infections requires clinical and laboratory data that are completed by the contribution of imaging procedures. Neuroimaging provides precise information on correct topography, localization, propagation, and differential diagnosis of spinal infectious lesions. The aim of this study was to present magnetic resonance imaging (MRI) findings in patients with postoperative spondylodiscitis.
  
  
  METHODS
  MRI was performed in 6 patients aged 29-50, with clinically suspected postoperative spondylodiscitis. Initial examination was performed 3-8 weeks after surgery and 3, 6, or 12 months after the treatment by antibiotics. Patients underwent MRI on a IT imaging unit (Siemens, Magnetom-Impact), including sagittal T1W and T2W images and axial T1W images before and after the administration of gadolinium contrast medium.
  
  
  RESULTS
  MRI findings included: significantly decreased signal intensity with the loss of distinction between vertebral body and intervertebral disc space on T1W, increased signal intensity in the adjacent vertebral body and end-plates on T2W, contrast enhancement of vertebral body and disc space and paravertebral soft tissue changes. Follow-up examinations performed 3, 6, or 12 months after the treatment showed less abnormal signal intensities on both T1- and T2-weighted images.
  
  
  CONCLUSIONS
  Postoperative spondylodiscitis is a rare but severe complication of lumbar disc surgery. Since conventional imaging techniques are not reliable for detecting spondylodiscitis in its early stages, MRI is of great significance in the diagnosis of postoperative spondylodiscitis.
authors.affiliation: Clinical Center of Serbia, Center of Magnetic Resonance, Belgrade, Serbia and Montenegro. tanja.stosic@kcs.ac.yu
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stosić-Opinćal
authors.forename: Vesna
authors.initials: V
authors.lastname: Perić
authors.forename: Danica
authors.initials: D
authors.lastname: Grujicić
authors.forename: Svetlana
authors.initials: S
authors.lastname: Gavrilović
authors.forename: Ivana
authors.initials: I
authors.lastname: Golubicić
mesh_terms: D000328:Adult; D015299:Discitis / Q000175:diagnosis* / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008875:Middle Aged