Infectious Spondylitis Mimicking Osteoporotic Vertebral Compression Fractures: Report of Two Cases

STUDY DESIGN: Case study of two cases. OBJECTIVES: The aim of our study is to describe the rare MR imaging patterns of infectious spondylitis. SUMMARY OF LITERATURE REVIEW: It is generally accepted that the intravertebral cleft sign is not shown in cases of infection or malignancy, and thus, its recognition can obviate unnecessary imaging or biopsy because of its benign significance. MATERIALS AND METHODS: Two patients are presented who developed worsening back pain after a minor trauma. Preoperative MR images of these patients showed intravertebral fluid and benign vertebral compression fractures. Anterior decompression and fusion were done and the bacteria isolated from the intraoperative cultures were Listeria monocytogenes and Mycobacterium tuberculosis, respectively. RESULTS: After 2 years of follow-up, the patients were free of pain, without signs of infection, and showed correct fusion. CONCLUSIONS: MR findings in infectious spondylitis may simulate the patterns of osteoporotic VCFs.

A Case Report of Intradural Ruptured Lumbar Disc

Intradural ruptured discs are very rare occurrences and the incidence is reported to be 0.13% among total herniated discs, 90% of intradural ruptured discs are known to occur in the lumbar area. The symtoms and signs of the intradural disc are much more severe than those of the usual extradural herniated disc. MR imagings of the intradural disc demonstrate several typical findings, but intradural tumors must be ruled out. The authors present a case of intradural ruptured lumbar disc L4-L5 level in a 46-year-old female. Characteristic MR and operative findings of this case are reported. Pathogenetic mechanisms and differential diagnoses with certain intradural tumors and the extradural ruptured disc with similar MR findings are discussed.