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Impact of Comorbidities on MRI Findings in Patients with Vertebral Osteomyelitis

AIM: The aim of our study was to analyze clinical and magnetic resonance imaging (MRI) findings in patients with vertebral osteomyelitis and to determine the impact of comorbidities on MRI findings. METHODS AND MATERIALS: A retrospective study of 110 patients with confirmed vertebral osteomyelitis, treated in 5-year period. Patients included in the study had clinical and biological examinations and MRI done according to the same protocol. For all patients modified Charlson comorbidity index (CCI) score was calculated and put in correlation with MRI findings. RESULTS: Sixty-three (57.3%) patients had one or more comorbidities: degenerative spine disease (31.2%), diabetes mellitus (20.4%), rheumatic inflammatory disease (12.9%), cardiovascular disease (10.8%), liver cirrhosis (8.6%), chronic renal failure (6.5%), malignancy (6.5%), alcochol abuse (3.1%). Thirty-seven (33.6%) patients had a high modified CCI score of 2 or more. High CCI score was associated with advanced MRI changes (p=0.006). Patients with advanced MRI changes more frequently underwent surgical intervention and were longer treated with antibiotics than patients with initial MRI changes of vertebral osteomyelitis (p=0.007 and p=0.004, respectively). CONCLUSION: The advanced MRI changes in patients with vertebral osteomyelitis are more often observed in patients with high CCI score, probably due to impaired immune response caused by diabetes or chronic renal failure or because of partial modulation of the immune response with medications in patients with inflammatory rheumatic diseases. Except degenerative spine disease, the distribution of comorbidities in patients in our study was similar to the previously conducted studies in which degenerative spine disease as comorbidity was not observed.

MRI; vertebral osteomyelitis; disease outcome

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