[Vertebral destruction syndrome. Diagnostic evaluation systems].
BACKGROUND
Vertebral Destruction Syndrome (VDS) is a pathology of multiple etiologies causing structural alterations of the spine, producing deformity with neurological and mechanical alterations. In order to study VDS, a diagnostic process is carried out, sometimes with unexpected results. We undertook this study to validate the systematization of a series of studies to arrive at the diagnosis of VDS.


METHODS
We included 105 patients in the study with diagnosis of VDS from January 1998 to December 2005, taking into consideration specificity, sensitivity and predictive value of each integrated study in order to determine its diagnostic value.


RESULTS
The most frequent etiology was Pott's Disease (24 cases) followed by osteomyelitis (20 cases), metastasis (18 cases) and multiple myeloma and plasmacytoma (16 cases each). The higher sensitivity in Pott's Disease was obtained with bone scan and polymerase chain reaction (PCR); for multiple myeloma, computerized axial tomography (CAT) and bone scan; CAT and bone scan for infections; MRI for primary tumors; and MRI and bone scan for secondary tumors.


CONCLUSIONS
To reduce false positives to 2% and to reduce the maximum number of false negatives, studies such as CAT, MRI, bone scan, PCR, ESR, C-reactive protein and determination of alkaline and acid phosphatase must be included in the VDS study protocol. Other studies have very low diagnostic sensitivity and specificity.
Alpizar-Aguirre
Armando
A
Instituto Nacional de Rehabilitación (INR), Secretaría de Salud, México, D. F.
Elías-Escobedo
Alejandro
A
Rosales-Olivares
Luis M
LM
Miramontes-Martínez
Víctor
V
Reyes-Sánchez
Alejandro
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000175:diagnosis*; D013125:Spinal Neoplasms / Q000175:diagnosis; D013577:Syndrome; D014399:Tuberculosis, Spinal / Q000175:diagnosis; D055815:Young Adult