Abstract

BAZAN, Pedro L. et al. Aspectos morfológicos del absceso epidural espinal piógeno. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2023, vol.88, n.2, pp.148-155. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2023.88.2.1513.

Introduction: A pyogenic spinal epidural abscess is an infectious collection inside the spinal canal, outside the dural sac. The diagnosis is difficult and the consequences are devastating due to compression or vascular compromise. MRI has a high diagnostic sensitivity and specificity, which improves when a contrast medium is used. Objectives: To determine the inter- and intra-observer reproducibility, and to discriminate the different parameters and differences between specialties. Materials and Methods: Twenty-seven independent observers evaluated 5 parameters: region, location, involvement, association, and perivertebral, anterior, lateral, or posterior extravertebral abscess. The kappa coefficient was used to analyze 35 cases on three occasions. Results: The overall intra- and inter-observer global agreement level is kappa 0.76, with the following values obtained: region 0.94; location 0.88; involvement 0.55; association 0.67 and perivertebral abscess 0.77. The first three parameters indicate volume, while the final two indicate the presence of vertebral infectious foci outside the canal. Conclusions: The proposed morphological classification is simple to use and has high intra- and inter-observer reproducibility. The most reproducible parameters are region and location (>0.87).

Keywords : Infection; epidural; abscess; osteomyelitis; spondylodiscitis; classification; magnetic resonance.

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