LAUSR

Background Brucellar spondylodiscitis is an important complication of brucellosis that can cause neurologic involvement and spinal deformities if not appropriately treated. Imaging examination is a major key in diagnosis Objectives The aim of this study was to report the imaging findings in brucellar spondylodiscitis Methods We performed a retrospective study including 27 patients with Brucellar spondylodiscitis over a period of 17 years from 2000 to 2016. Diagnosis was made on clinical presentation, laboratory findings, radiographic evidence and Brucellar seroagglutination tests. All patients underwent X-rays of the involved spine levels. Spinal computed tomography (CT)was carried out in 13 cases and spinal MRI in 24 cases Results seventeen men and 10 women aged from 33 to 75 years were included. Plain radiographs showed a disc space narrowing for 26 patients (96,3%) and an irregularity of the vertebral end plate in 16 cases (59,3%). A paravertebral abscess formation was detected for 3 patients. No obvious abnormalities were found in one case. CT scans of most patients revealed signs of spondylodiscitis (92,3%). This examination showed an erosion of the vertebral end plates (69.2%), intervetebral disc space narrowing (61,5%)and bone destruction (38.5%). The severity signs detected on the CTs were the soft tissu thickening (46.2%), abscesses formations (7.4%), epiduritis (30.8%) and one patient had a spinal cord compression. The 24 MRIs realised exhibited a signal abnormality of the vertebral body (95.7%) and the intervertebral disc (47.8%) in addition to disc space narrowing (73.9%) with erosions of the vertebral end plates (56.0%). The contrast enhanced T1-weighted images showed marked enhancement of affected vertebrae and disc (78.3%). Thirteen patients had abscesses formations (56,5%), 17 had epiduritis (73,9%) and 9 patients (31,9%) presented a spinal cord compression on MRI. Brucellar spondylodiscitis involved one spinal level in 23 cases whereas multilevel involvement was found in the 4 others Conclusions plain radiographs and spinal CT scans luck sensitivity in diagnosing brucellar spondylodiscitis and spinal MRI remains the referential imaging modality to recognise early bone infection, allowing complete lesion topography and identifying the complications. Disclosure of Interest None declared