Abstract

Aim: To describe the radiological features of spinal tuberculosis on Magnetic Resonance Imaging and study the role of MRI in assessing the extent of disease.

Materials and Methods: This was a descriptive study conducted at the department of Radiodiagnosis in Government Medical College and Dr Susheela Tiwari Memorial (STM) Hospital, Haldwani. This study was carried out on 61 cases of tuberculosis of spine. Plain radiograph of spine and chest, followed by MRI features were observed on T1weighted, T2weighted and short tau inversion recovery (STIR) sequences. The diagnosis was based on history, clinical evaluation and characteristic radiological features on MRI along with response to treatment. Pathological correlation was done for detection of AFB wherever possible.

Results: The disease was most commonly seen in young adults and a male predominance was noted. Backache in 52 (86.6%) and low grade fever were found to be the most common clinical features followed by weight loss and paraparesis. Dorso-lumbar spine was most commonly involved in 25 (40%), followed by dorsal, lumbar and sacral vertebrae. MRI findings included bone marrow edema in 61(100%), end plate irregularities in 61(100%), disc space reduction in 30(50%), pre and paravertebral collection in 28(46.7%), calcification in 25(41%), spinal cord compression in 16(26.6%). Neurological symptoms were found in patients with degree of spinal canal compression exceeding 20%.Vertebral body wedge collapse in 30(50%), compression fracture in 16(26.6%) and combination of both were noted in 4(6.67%). Kyphosis in 26 (43.3%) and scoliosis in 5(8.3%) was also noted. Paradiscal pattern of involvement was most commonly found.

Conclusion: Tubercular spondylitis is best evaluated on MRI as it provides critical information ranging from simple edema involving vertebrae and intervertebral discs to paraspinal collections and abscesses and vertebral collapse leading to spinal cord compression in patients with neurological deficit. Knowledge of the spectrum of various MR imaging features in spinal tuberculosis is of utmost importance in limiting the morbidity caused by this disease by helping in early diagnosis and guiding the course of treatment.