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Diagnostic Yield of Computed Tomography-Guided Procedures for Spondylodiscitis

  • Clinical Investigation
  • Non-Vascular Interventions
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Abstract

Purpose

To identify the diagnostic yield and predictive factors for microbiological diagnosis in patients with spondylodiscitis through computed tomography (CT)-guided biopsy or aspiration.

Materials and methods

A retrospective review of 102 patients with suspected spondylodiscitis who underwent CT-guided procedures in an 8-year period was conducted. Analyzed variables were demographic data, C-reactive protein, pre-biopsy MRI findings, prior antibiotic use, site of biopsy/aspiration, histopathological findings, culture results and radiation dose.

Results

The culture yield among all sites was 56%, 85.6% for paravertebral/discal fluid aspiration, 66.7% for disk-only biopsy, 52.9% for paravertebral soft tissue biopsy, and 39.6% for endplate bone-disk unit. Patients with paravertebral/disk collection on MRI had better yields when submitted to fluid aspiration instead of biopsy of other sites (78.9% vs. 36.6%; p = 0,006). Pyogenic etiology corresponded to 68.3% of cases and Staphylococcus aureus was the most common agent. Prior antibiotics exposure was associated with a lower yield (66.2% vs. 40.9%, p = 0,016).

Conclusions

CT-guided procedures are safe and well-tolerated in patients with suspected spondylodiscitis, with good microbiologic yield particularly in the presence of paravertebral/discal abscess.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Interventional Radiology, Department of Radiology, University of São Paulo Medical School, Av. Dr. Enéas Carvalho de Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil

    Lucas Vatanabe Pazinato, Felipe Shoiti Urakawa, Daniel Takeshi Setuguti & Marcos Roberto de Menezes

  2. Interventional Radiology, Department of Radiology, Sao Paulo State Cancer Institute (ICESP), Av. Dr. Arnaldo, 251, Sao Paulo, SP, 01246-000, Brazil

    Joaquim Mauricio da Motta-Leal-Filho & Marcos Roberto de Menezes

Authors
  1. Lucas Vatanabe Pazinato
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  2. Felipe Shoiti Urakawa
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  4. Joaquim Mauricio da Motta-Leal-Filho
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Correspondence to Lucas Vatanabe Pazinato.

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Pazinato, L.V., Urakawa, F.S., Setuguti, D.T. et al. Diagnostic Yield of Computed Tomography-Guided Procedures for Spondylodiscitis. Cardiovasc Intervent Radiol 45, 800–807 (2022). https://doi.org/10.1007/s00270-022-03132-z

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  • DOI: https://doi.org/10.1007/s00270-022-03132-z

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