Spontaneous spondylodiscitis: presentation, risk factors, diagnosis, management, and outcome

Initial MRI from patient 6: sagittal T2 (a), T1 (b), and post-gadolinium sagittal (c) and axial (d) T1 images show increased signal of the L3–L4 intervertebral disc (arrow), bone marrow edema of the adjacent vertebral bodies, and contrast enhancement of the vertebral body. There is paraspinal infection and extension of the infection to the epidural space up to the level of T11, producing canal stenosis (arrowhead).

Follow-up MRI at 6 weeks from patient 6: sagittal T2 (a), T1 (b), and post-gadolinium sagittal (c) and axial (d) T1 images show improvement of the intervertebral disc signal on T2 images, more extensive bone marrow edema of the L3–L4 vertebral bodies, more extensive post-gadolinium enhancement of the vertebral body and the intervertebral disc, but improvement of the epidural and paraspinal abscesses.

Follow-up MRI at 12 months from patient 6: sagittal T1 before (a) and after (b) contrast administration and T2 images (c). There are no signs of infection.