====== Destructive lesions of the spine ====== ===== Etiologies ===== 1. neoplastic; see Differential diagnosis: spine & [[spinal cord tumor]]s for more: a) metastatic tumors with a predilection for bone:prostate,breast,renal cell,lymphoma,thy- roid, lung...; see [[Spinal epidural metastases]]. b) primary bone tumors:[[chordoma]]s,osteoid osteoma,[[hemangioma]] 2. infection: a) vertebral osteomyelitis: occurs mostly in IV drug abusers,patients with diabetes mellitus, and hemodialysis patients. May have associated spinal epidural abscess. Also see [[Vertebral osteomyelitis]] b) [[Discitis]] 3. [[chronic renal failure]]: some patients develop a destructive spondyloarthropathy that resembles infection11,12 4. [[ankylosing spondylitis]]: bamboo spine (square VBs with bridging syndesmophytes) 5. lesions producing posterior scalloping of VB (mnemonic: AMEN) A [[acromegaly]] or [[achondroplasia]] M Marfan syndrome or mucopolysaccharidosis E Ehlers-Danlos N neurofibromatosis also: [[dural ectasia]] 6. lesions producing anterior scalloping of VB a) aortic aneurysm b) lymphoma c) spinal TB