Euba G et al. – Most patients with abscess-associated spontaneous pyogenic vertebral osteomyelitis (PVO) are cured with a conservative approach. MRI shows STI reduction at ER evaluation. Repeat MRI is probably unnecessary if clinical and laboratory outcomes are satisfactory. Methods
This study evaluates the clinical and MRI outcome of abscess-associated PVO under conservative treatment
Pts with spontaneous PVO in whom the initial MRI showed soft-tissue involvement (STI)
Treatment according to a medical protocol, clinical and MRI f/u at diagnosis, and at 2 later time points: early response, and late response
MRI classified STI as soft-tissue edema (STE) or abscess
Results
Of the 27 pts, all had pain, 63% had fever, and 22% had mild neurological impairment
The main etiology was Staphylococcus sp (41%)
81% had bacteremia and 67% had epidural/paraspinal abscess
Pts received antibiotics for 9 wks, administered orally for 6 wks
ER: Three cases failed and general improvement was seen in the remainder
MRI showed persistent STI, which diminished in all cases except 1, whereas bone/disc findings remained
LR: All pts were cured; 8 reported mild sequelae (30%)
MRI still revealed bone/disc abnormalities, but residual STE was infrequent
See all
