Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

Abstract Background Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed need for magnetic resonance imaging entire spine exclude multisegmental infections and determine required surgical interventions. The aims this study were assess incidence multilevel non-contiguous pyogenic SpD compare comorbidities, pain symptoms, subsequent strategies between unifocal (uSpD) multifocal (mSpD) SpD. Methods We retrospectively evaluated data patients with confirmed, surgically treated, who had received a total MRI in single center 2016 2018. findings classified according Pola-classification demographics, duration clinical (pain neurology) Charlson Comorbidity-Index (CCI) results compared uSpD und mSpD groups. Surgical therapy was mSpD. Results detected by 69 79 (87%). Of these, 10 (13%) 21 infected segments (cervical and/ or thoracic lumbar region). Age CCI similar 24 all regions clinically unapparent. All treated operatively. In seven mSpD, levels one-stage procedure; one patient two-stage procedure surgery at spine, additional segment upper conservatively. One died before planned performed. Conclusions being found approximately 13% cases, considering risk overlooking case, recommended. detection multiple infection can have impact on therapeutic strategy chosen.