MR evaluation of spinal tuberculosis

Objectives: The purpose of the study is to describe the radiological features of spinal tuberculosis on MRI (magnetic resonance imaging) and plain radiograph and the role of MRI in assessing the extent of disease, to assess the degree of cord/ thecal sac compression and to correlate with neurological deficit. Methods: This study was done on prospective basis in 30 patients with clinical suspicion of Pott's spine. Plain radiograph of the spine and chest was done followed by MRI of spine were done in all the patients. Various MRI features were observed on non-contrast T1W, T2W and STIR sequences followed by post-contrast T1W sequences and degree of cord compression was correlated with neurological deficit. The characteristic radiological features on plain radiograph and MRI along with response to treatment were considered diagnostic. Results: Back pain and low grade fever were most common clinical complaints followed by paraparesis and sensory deficit. Neurological symptoms were found in patients with degree of spinal canal compression exceeding 20%. Dorsal vertebrae were most commonly involved followed by lumbar and sacral vertebrae. Vertebral body wedge collapse, compression fracture and combination of both were evaluated. Prevertebral and paravertebral abscesses and epidural phlegmon were seen more on MRI. Conclusions: MRI is the best diagnostic modality for spinal TB and is more sensitive than plain radiography. It provides the diagnosis of spinal TB earlier than conventional methods, offering the benefits of earlier detection and treatment.