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Research article
Chang Ho Kang
Korea University Anam Hospital
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background: Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response.
Methods: A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test.
Results: The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n=19, resolving: n=19, and aggravated: n=10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n=8, resolving: n=22, and worsened: n=18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01).
Conclusion: Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
Keywords
Spine, Infection, Magnetic resonance imaging, c-reactive protein, erythrocyte sedimentation rate
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CURRENT STATUS: Published
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Posted 20 Jun, 2020
Published
On 02 Jul, 2020
No community comments so far
Editorial decision: Accept
On 19 Jun, 2020
Editor assigned
On 19 Jun, 2020
Editor invited
On 18 Jun, 2020
Submission checks complete
On 07 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 15 Jun, 2020
Editor assigned
On 19 May, 2020
Editor invited
On 18 May, 2020
Submission checks complete
On 07 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 06 May, 2020
Reviewer #2 agreed
On 02 May, 2020
Review #2 received
Received 02 May, 2020
Review #1 received
Received 01 May, 2020
Reviewer #1 agreed
On 30 Apr, 2020
Reviewers invited
Invitations sent on 29 Apr, 2020
Editor assigned
On 16 Apr, 2020
Submission checks complete
On 15 Apr, 2020
Editor invited
On 15 Apr, 2020
No comments provided
Review #1 received
Received 20 Mar, 2020
Editorial decision: Major revision
On 20 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Reviewer #2 agreed
On 18 Mar, 2020
Reviewer #1 agreed
On 10 Mar, 2020
Editor assigned
On 09 Mar, 2020
Reviewers invited
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On 03 Mar, 2020
Editor invited
On 02 Mar, 2020
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Chang Ho Kang
Korea University Anam Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 20 Jun, 2020
Published
On 02 Jul, 2020
No community comments so far
Editorial decision: Accept
On 19 Jun, 2020
Editor assigned
On 19 Jun, 2020
Editor invited
On 18 Jun, 2020
Submission checks complete
On 07 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 15 Jun, 2020
Editor assigned
On 19 May, 2020
Editor invited
On 18 May, 2020
Submission checks complete
On 07 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 06 May, 2020
Reviewer #2 agreed
On 02 May, 2020
Review #2 received
Received 02 May, 2020
Review #1 received
Received 01 May, 2020
Reviewer #1 agreed
On 30 Apr, 2020
Reviewers invited
Invitations sent on 29 Apr, 2020
Editor assigned
On 16 Apr, 2020
Submission checks complete
On 15 Apr, 2020
Editor invited
On 15 Apr, 2020
No comments provided
Review #1 received
Received 20 Mar, 2020
Editorial decision: Major revision
On 20 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Reviewer #2 agreed
On 18 Mar, 2020
Reviewer #1 agreed
On 10 Mar, 2020
Editor assigned
On 09 Mar, 2020
Reviewers invited
Invitations sent on 09 Mar, 2020
Submission checks complete
On 03 Mar, 2020
Editor invited
On 02 Mar, 2020
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background: Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response.
Methods: A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test.
Results: The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n=19, resolving: n=19, and aggravated: n=10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n=8, resolving: n=22, and worsened: n=18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01).
Conclusion: Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
Figure 1
Figure 2
Figure 3
Figure 4
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