The Imaging of Spinal Infections

Spinal infections can arise in a variety of anatomical locations and structures and encompass vertebral osteomyelitis, discitis, disc space infection, epidural abscesses, and infection of the adjacent soft tissue structures. Plain radiography, computed tomography, magnetic resonance imaging (MRI), and nuclear imaging all have a role in the diagnosis of spinal infection. MRI continues to be the gold standard for the imaging diagnosis of spinal infections. 67Gallium citrate and Tc-99m-methylene diphosphonate scintigraphy have become the standard for nuclear imaging of the spine. Fluorine-18-fluorodeoxyglucose positron emission tomography, strepavidin/111In-biotin, and 99m-ciprofloxacin have shown promise for aiding in the diagnosis and evaluation of spinal infection but warrant further study.