Spinal Problems Bone Infection

Infections involving the bones and discs of the spine are uncommon, but can have serious consequences. Some of the most common infections of the spine’s bones and discs include osteomyelitis, discitis, and spinal epidural abscess.

Osteomyelitis

Vertebral osteomyelitis is a spinal bone infection that most commonly occurs in the vertebrae, but can also affect the intervertebral discs and the area surrounding the spinal cord. The cause is usually due to bacteria or fungi,. It most often occurs in young children or older adults.

Symptoms of osteomyelitis include:

  • Fever
  • Persistent, severe back pain that is worse with movement
  • Sweating
  • Swelling, warmth, redness, and tenderness at the infection site
  • Weight loss.

If the infection spreads into the space around the spinal cord, symptoms may include severe, radiating back pain and muscle weakness. Severe osteomyelitis can lead to paralysis.

The treatment for osteomyelitis is often broad-spectrum antibiotics. Severe cases often require surgery, which may include draining the infection, removing infected bone, and rebuilding the spine. If treatment is not completely effective, osteomyelitis may develop into a low-grade condition that comes and goes for months or years.

Discitis

Discitis is the inflammation of the intervertebral discs, and is often related to an infection. Medical opinion varies as to the cause of discitis, though it may spread to the discs from a bacterial infection in another part of the body or occur as a result of irritation caused by spine surgery.

The symptoms of discitis are similar to those of osteomyelitis. Discitis and osteomyelitis can occur together.

Treatment for discitis may include broad-spectrum antibiotics, immobilization, and pain medication. Surgery may be necessary if neurological problems or spinal deformities develop, or if the discitis doesn’t respond to other treatments. The goal of surgery is to remove diseased tissue, decompress neural structures, and make sure the spine is stable.

Spinal Epidural Abscess

A spinal epidural abscess is a collection of pus between the outer covering of the spinal cord and the vertebrae. It’s caused by infection in the area between the vertebrae and the membranes covering the spinal cord (known as “meninges”).

A spinal epidural abscess is most likely to occur if a person has experienced:

  • Back surgery or other invasive procedures involving the spine
  • Bloodstream infections
  • Boils
  • Vertebral osteomyelitis.

Treatment usually includes both intravenous antibiotics and surgery to drain or remove the abscess. Surgery may also be required to reduce pressure on the spinal cord in order to prevent more loss of function.

Resources

Cedars-Sinai Staff (n.d.). Osteomyelitis. Retrieved March 26, 2010, from http://www.csmc.edu/5746.html

Jallo, G. (2009). Diskitis. Retrieved March 26, 2010, from http://emedicine.medscape.com/article/1263845-overview

Young, M. and Richard T. Holt. (2010). Infections of the spine. Retrieved March 26, 2010, from http://www.spineuniverse.com/conditions/spinal-disorders/infections-spine-0

University of Maryland Health Center Staff. (2008). Epidural abscess — All information. Retrieved March 26, 2010, from http://www.umm.edu/ency/article/001416all.htm