Abstract

MRI: A RADIOLOGICAL DIAGNOSTIC MODALITY AND TECHNOLOGY DEVELOPMENT IN SPINAL TUBERCULOSIS

Anil Yadav*, Dr. Nouratan Singh, Dr. A. K. Gupta, Dr. (Brig.) T. Prabhakar and Dr. Ramakant Yadav

Abstract

A round the world’s one-third population is infected with TB infection which occurs in about 1% of the population each year. There were 9.6 million cases of active tuberculosis which resulted in 1.5 million deaths in 2014. In developing countries about more than 95% of deaths occurred due to TB infection. The commonest extrapulmonary manifestation of TB is spinal tuberculosis. Spinal TB spreads through hematogenous route in the body. In spinal tuberculosis clinically it present with constitutional symptoms such as back pain, paraparesis or paraplegia, tenderness, and kyphotic or scoliotic deformities in patient. In present MRI is the preferred imaging modality, preferred technique to define the activity and extent of infection in patients with suspected spinal tuberculosis for better diagnosis. The objective of the study is to describe various radiological features of spinal tuberculosis on MRI and to assess its role in evaluation of the extent of disease in this concern. Spinal tuberculosis is a destructive form of tuberculosis, it accounts for approximately half of all cases of musculoskeletal tuberculosis in U.P. RIMS & R. Spinal tuberculosis is more common in young adults. In developing nations the incidence of spinal tuberculosis is increasing. Recently genetic susceptibility to spinal tuberculosis has been demonstrated. In spinal tuberculosis, there is destruction of the intervertebral disk space and the adjacent vertebral bodies due to push formation, collapse of the spinal elements, kyphosis and gibbus formation in the back. The thoracic or dorsal region of vertebral column is most frequently affected due to spinal tuberculosis. In generally clinical manifestations including constitutional symptoms, spinal tenderness, back pain, paraplegia and spinal deformities in the patient of spinal tuberculosis. For the better diagnosis for treatment of spinal tuberculosis magnetic resonance imaging is highly sensitive and specific imaging technique than others like x-ray and computed tomography. MRI frequently indicates involvement of the vertebral bodies on either side of the disk, vertebral collapse, disk destruction, cold abscess, presence of vertebral column deformities finding in patient. Involvement of the spinal column is less than 1% of all cases of tuberculosis (TB). It is a very dangerous type of skeletal TB because it can be associated with neurological abnormalities due to compression of adjacent neural structures and significant spinal deformity in patient. So, early diagnosis and management of spinal tuberculosis has also a special importance in preventing these serious complications in patient suffering from spinal tuberculosis. Therefore the development of more accurate imaging modality such as magnetic resonance imaging for advanced diagnosis of spinal TB much easier, this is very challenging and interesting topics.

Keywords: Tuberculosis, Spinal tuberculosis, Magnetic Resonance Imaging, Abscess, Pott’s spine.