AB1124 PREDICTIVE VALUE OF MRI FOR CT-GUIDED POSITIVE BIOPSY IN SUSPECTED INFECTIOUS SPONDYLODISCITIS

Background Spondylodiscitis is a potentially life-threatening infection burdened by high morbidity rates. MRI remains the key examination in the diagnosis of infectious spondylodiscitis. The microbiological diagnosis is the main predictive factor for successful treatment. Objectives To evaluate the MRI characteristics associated with the detection of microbial pathogens by computed tomography (CT) guided biopsy in case of suspicion of infectious spondylodiscitis. Methods Retrospective study including all patients hospitalized in our department between 1999 and 2019 and who underwent MRI and CT-guided biopsy for suspicion of septic spondylodiscitis.The diagnosis was based on clinical, biological, radiological and bacteriological data. We divided the patients into two groups: patients with a non-contributory CT guided biopsy (group 1) and patients with a contributory biopsy (Group 2). Results We included 82 patients including 37 women and 45 men with a mean age of 56 years old [16 - 86]. The median delay of consultation was 3 months. Inflammatory back pain was reported in 78% of cases. Neurologic deficiency was noticed in 19.5% of cases. The lumbar spine was involved more than 50% of cases. Spinal MRI was performed to all patients and showed paravertebral abscess in 64.6%, epiduritis in 62.1%,intra-discal abscess in 3.6%, spinal cord compression 10.9%, and vertebral ostelysis in 6.09% of cases.The causative microorganism was mycobacterium tuberculosis in 53.6%, brucella in 24.3%, and pyogenic germs in 15.8% of cases. Disco vertebral biopsy was performed in 55 patients and was contributory in 45.4% of cases. The presence of spinal cord compression, intra-discal abscess and vertebral osteolysis was more frequent in group 2, but with no statistically significant difference (p = 0.65, 1 and 0.58; respectively). In addition, there was no significant difference in the presence of paravertebral abscess and epiduritis (p = 0.41 and 0.53; respectively). Conclusion Spondylodiscitis is an emergency which must be diagnosed on time to avoid life threatening complications, neurological sequelae and spinal deformities. Disclosure of Interests None declared