Evaluation of spinal infections by plain radiographs, computed tomography, intrathecal metrizamide, and CT-guided biopsy.

16 cases of spinal infection were reviewed to evaluate the usefulness of plain radiographs, noncontrast computed tomography (CT), computed tomographic metrizamide myelography (CTMM), plain film metrizamide myelography, and CT-guided biopsy techniques. Noncontrast CT was more useful than plain films in the evaluation of disc space and bony involvement and soft tissue extension of infection into the paraspinal spaces. CTMM was needed for evaluation of epidural or subdural involvement of infection in the cervical and thoracic spine, while plain film metrizamide myelography was useful as a survey for CTMM. CT-guided biopsy was definitive in establishing the etiology of the offending organism.