Turgut Tali E, guest ed. Mukherji SK, consulting ed. Spinal Infections. Elsevier; May 2015. Neuroimaging Clinics of North America; vol. 25, no. 1; pgs. 159–326, $360.00
Under the editorship of Dr. Tali, the May 2015 issue of the Neuroimaging Clinics of North America deals with a critical issue in orthopedics, neurosurgery, and medical care: spinal infections. An international group of authors (27 in all) have tackled this subject in 11 chapters covering 165 pages, including 2 short chapters on the pathology of spinal infections followed by chapters on pediatrics pyogenic, tuberculosis, brucellosis, and viral parasitic infections. The final 3 chapters deal with image-guided interventions, neurosurgical approaches to infections, and complications/sequelae of spinal infections.
A particularly troubling area of spinal MR is trying to clearly distinguish between severe degenerative disc disease/arthritis with aspectic inflammatory changes versus an infectious osteodiscitis. Although this dilemma is briefly mentioned in a few chapters such as the one on pyogenic spinal infections, the issue is of such importance that a separate chapter on this specific topic should have been included. After all, what is one more likely to encounter, a parasitic infection of the spine/brucellosis of the spine (these chapters together have 32 pages) or severe degenerative disc disease where the clinical signs and laboratory results are nonconclusive? Disappointing also is the lack of a substantial amount of information and imaging on advanced MR techniques. A few scattered DWI images appear, but no specific chapter is devoted to where nonroutine techniques are or could be helpful. An issue of the Neuroimaging Clinics of North America is a proper place for an author of one chapter to look to the future, perhaps indicating where those studies could be potentially helpful.
Noteworthy is the chapter “Pediatric Spinal Infection and Inflammation” by Dr. Rossi, not just because it contains well-chosen illustrations and describes lesions well but because it clarifies some of the terminology that is often used imprecisely. Contained in this chapter are useful clinical correlates of the specific disease under consideration. Here again, and as mentioned above, the inclusion of some “advanced” imaging such as both positive and negative DWI in the cases of spinal cord abscess vs. a noninfectious but localized inflammatory process would have been a substantial addition to the book.
Those criticisms aside, there are interesting cases/images in each chapter, and the material is informative. Perhaps it is the prescribed limitations of pages that prevented the development of a more robust issue. Nonetheless, as part of the overall series, this issue has educational value.
