A

B

C

COLLAPSED VERTEBRAL BODIES

• Metastases & myeloma

• Infections

• Osteoporosis & osteomalacia

• Trauma

• Eosinophilic granuloma

LYSIS WITHIN A VERTEBRA

• Metastases – primary tumors of lung, breast, kidneys

• Multiple myeloma / Plasmacytoma

• Malignant lymphoma

DENSE VERTEBRA

• Metastases – primary tumors of prostate, breast.

• Malignant lymphoma

• Paget’s disease

• Hemangioma

POTT’S DISEASE (TB SPINE)

• Spine is MC site of bone & joint TB.

• Types of vertebral TB

A) paradiscal B) Central C) Anterior D) posterior

Radiological examination:

a) Reduction of disc space

b) Destruction of vertebral body- contiguous margins, wedging, angular kyphotic deform.

c) Evidence of cold abscess.

d) Psoas, retropharyngeal abscess.

e) Widening mediastinum.

VERTEBRAL METASTASES • Bone destruction & replacement of marrow signal by tumor on MRI

• Disc space is normal

Classification of vertebral lesions :

Grade1: partial or total vertebral invasion without bony deformity

Grade2: hypo intense in T1 & hyperintnse in T2-wieghted sequences

Grade3 : impaction fracture of vertebral body

Grade4: due to involvement of vertebral body and articular processes, there is

displacement # most often complicates by neurological compromise

Thoracolumbar# classification

Anterior column : wedging with pain in upright position no neurological sign

Middle column: little instability/pain, an intact posterior long lig rep a barrier that turns ext to for. Post column: pain instability, severe neurological compromise

Tomita’s classification 8 grades of increasing severity

Thank you

References :a)Harrisons INT medicineb) Abeloff oncologyc)Peter Armstrong's diagnostic imaging

Vertebral osteomyelitis

•Vertebral osteomyelitis (also termed spinal osteomyelitis, spondylodiskitis, septic diskitis, or disk-space infection) may be acute (i.e., evolving over a period of a few days or weeks) or sub-acute or chronic (i.e., lasting for weeks or months before antimicrobial therapy is initiated).

•Vertebral osteomyelitis most often results from hematogenous seeding, direct inoculation at the time of spinal surgery, or contiguous spread from an infection in the adjacent soft tissue.

•Staphylococcus aureus is the most common.

•Most patients with hematogenous pyogenic vertebral osteomyelitis have underlying medical diseases — especially diabetes, coronary heart disease, immunosuppressive disorders, cancer, or renal failure requiring hemodialysis — or use intravenous drugs

•Vertebral osteomyelitis can be complicated by direct seeding in different compartments, resulting in paravertebral, epidural, or psoas abscesses