Role of MR imaging in the management of spinal infections.

Infection of the spine is a major category of spinal disease that is difficult to differentiate clinically from degenerative disease, noninfective inflammatory lesions, and spinal neoplasm. The infection can affect the vertebrae, intervertebral disks, paraspinal soft tissues, the epidural space, the meninges, and/or the spinal cord. Specific causative organisms include bacteria (pyogenic, granulomatous), fungi, parasites (Echinococcus, Schistosoma), and viruses. Early diagnosis and prompt treatment are essential to prevent permanent neurologic deficit and/or spinal deformity. Imaging plays an important role in the overall evaluation of these lesions, and the ideal technique is expected to provide information that will help characterize and delineate the disease process, guide biopsy and/or drainage procedures, suggest method of treatment (medical vs surgical), and assess response to therapy. The aim of this article is to review the advantages and limitations of MR imaging in the management of spinal infections.