Scholarlink

Background <p>Tuberculous spondylodiscitis (TS), also known as Pott’s disease, is a rare but severe form of extrapulmonary tuberculosis. Magnetic resonance imaging (MRI) is the modality of choice for diagnosis and for assessing complications such as abscesses and neural compression. Data from low-incidence countries remain limited. The primary aim of this study was to describe MRI features of TS in a cohort of patients diagnosed in an Italian reference center.</p> Methods <p>A retrospective study was conducted including 22 adult patients with microbiologically and/or histologically confirmed TS evaluated between 2020 and 2025. All patients underwent pre-treatment spine MRI. Imaging features—including number and site of affected vertebrae, endplate changes, abscess formation, and neural involvement—were recorded. A four-point radiological severity score, developed at our institution for exploratory purposes and not previously validated, was used to summarize disease extent. Imaging findings were explored in relation to clinical variables such as symptom duration, hospital stay, and treatment strategy (including surgery). Treatment decisions (medical therapy alone, percutaneous drainage, or surgery) were based on a multidisciplinary evaluation considering neurological status, spinal stability, and abscess burden.</p> Results <p>The mean patient age was 36 years, with a predominance of males (82%). Most patients originated from high TB-prevalence regions. Multivertebral involvement was common (average 4 vertebrae per patient), predominantly affecting the lumbar (64%) and thoracic (59%) regions. Osteolysis (82%), paravertebral abscesses (82%), and epidural abscesses (59%) were frequent findings. Spinal cord or nerve root involvement was observed in 27% of cases. No clear associations were observed between radiological severity and symptom duration or length of hospital stay. Medical therapy alone was sufficient in 45% of cases, while 27% required additional percutaneous drainage and 27% underwent combined medical and surgical management.</p> Conclusion <p>In this Italian cohort, TS demonstrated MRI features consistent with the classical imaging phenotype described in the literature, including frequent multilevel involvement and abscess formation. MRI was useful in the evaluation of disease extent and detection of complications in our cohort. Given the exploratory nature of the radiological severity score, further studies are needed to validate standardized imaging-based assessment tools and to explore their potential clinical relevance in low-incidence settings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Tuberculous spondylodiscitis in a low-incidence setting: clinical and neuroradiological features in the diagnostic workflow of a tertiary center in Italy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月29日

查看全文
  • Teresa Perillo,
  • Annarita Botta,
  • Agostina Pontarelli,
  • Annalisa del Giudice,
  • Annunziata de Rosa,
  • Alberto Marra,
  • Luigi Massari,
  • Francesco Scarano,
  • Roberto Altieri,
  • Marcello Barbato,
  • Marco Giugliano,
  • Giuseppe Olindo,
  • Manlio Barbarisi,
  • Antonio Pinto,
  • Roberto Parrella

摘要

Background

Tuberculous spondylodiscitis (TS), also known as Pott’s disease, is a rare but severe form of extrapulmonary tuberculosis. Magnetic resonance imaging (MRI) is the modality of choice for diagnosis and for assessing complications such as abscesses and neural compression. Data from low-incidence countries remain limited. The primary aim of this study was to describe MRI features of TS in a cohort of patients diagnosed in an Italian reference center.

Methods

A retrospective study was conducted including 22 adult patients with microbiologically and/or histologically confirmed TS evaluated between 2020 and 2025. All patients underwent pre-treatment spine MRI. Imaging features—including number and site of affected vertebrae, endplate changes, abscess formation, and neural involvement—were recorded. A four-point radiological severity score, developed at our institution for exploratory purposes and not previously validated, was used to summarize disease extent. Imaging findings were explored in relation to clinical variables such as symptom duration, hospital stay, and treatment strategy (including surgery). Treatment decisions (medical therapy alone, percutaneous drainage, or surgery) were based on a multidisciplinary evaluation considering neurological status, spinal stability, and abscess burden.

Results

The mean patient age was 36 years, with a predominance of males (82%). Most patients originated from high TB-prevalence regions. Multivertebral involvement was common (average 4 vertebrae per patient), predominantly affecting the lumbar (64%) and thoracic (59%) regions. Osteolysis (82%), paravertebral abscesses (82%), and epidural abscesses (59%) were frequent findings. Spinal cord or nerve root involvement was observed in 27% of cases. No clear associations were observed between radiological severity and symptom duration or length of hospital stay. Medical therapy alone was sufficient in 45% of cases, while 27% required additional percutaneous drainage and 27% underwent combined medical and surgical management.

Conclusion

In this Italian cohort, TS demonstrated MRI features consistent with the classical imaging phenotype described in the literature, including frequent multilevel involvement and abscess formation. MRI was useful in the evaluation of disease extent and detection of complications in our cohort. Given the exploratory nature of the radiological severity score, further studies are needed to validate standardized imaging-based assessment tools and to explore their potential clinical relevance in low-incidence settings.