Differential Diagnosis Of Spinal Tuberculosis And Purulent Spondylitis

Objective The study was to investigate the computed tomography(C T) features diffe rentiating tuberculous spondylitis from pyogenic spondylitis.Methods The CT features in 32 patients with tuberculous spondylitis and 30 patients with pyogenic spondylitis were retrospectively reviewed, recorded and statis tically analyzed.Results In 32 cases of tuberculous spondylitis, 71 vertebral segments were involved. In 30 cases of pyogenic spondylitis, 59 vertebral segments were involved. The incidence of thoracic spine involvement in tuberculous spondylitis was 60.56%(43/71), it was higher than that of pyogenic spondylitis(25.42%,15/59), p<0.05. The incidence of lumbar spine involvement in tuberculous spondylitis was 33.80%(24/71), it was lower than that of pyogenic spondylitis(61.02%,36/59), p<0.05. The incidence of the worm-eaten type of bone destruction in tub erculous spondylitis was 9.90%(7/71), it was lower than that of pyogenic spondylitis(44.07%, 26/59), p<0.05. The incidence of the fragmentary type of bone destruction in tuberculous spondylitis was 19.72%(14/71), it was higher than that of pyogenic spondylitis(3.39%,2/59), p<0.05. The incidence of the involved vertebral height on sagital C T imaging is less than the 1 /2 of the normal vertebral height in tuberculous spondylitis was 16.9%(12/71), it was lower than that of pyogenic spondylits(62.71%,37/59), p<0.05. The incidence of patchy high density shadow in tuberculous spondylitis was 50.7%(36/71), it was higher than that of pyogenic spondylitis(20.34%,12/59), p<0.05. The incidence of the involvement of the appendages in tuberculous spondylitis was 25.35%(18/71), it was higher than that of pyogenic spondylitis(8.47%,5/59), p<0.05. The incidence of paravertebral abnormal soft-tissue with calcification in tuberculous spondylitis was 60.0%(18/30), it was higher than that of pyogenic spondylitis(20.0%,5/25), p<0.05.Conclusion Tuberculous spondylitis and pyogenic spondylitis had some charecteristic imaging features, combined with the clinical signs can they be differe ntiated from each other.