Understanding Spinal Infections

Any infection of the spine, whether caused by illness, injury or trauma requires a specialized course of medical intervention. Whether a non-surgical or surgical approach is recommended, medical intervention is necessary. Different types of infections can occur along the spine, which differentiate in instance and severity due to anatomical location.

There are three areas in which spinal infections can occur, and they include the intervertebral disc, vertebral column and the spinal canal.

Will I Have To Have Surgery?

Nonsurgical treatment is always considered first when physicians find minimal or no neurological indications. The nonsurgical management of spinal infections will include antibiotic or anti-fungal medications. The type and the duration of the treatment will be directly related to the severity of the infection and the organism causing the infection. Your course of treatment may be necessary intravenously and/or orally and ranging from 7-10 days, to as long as 6-12 weeks.

Types of Spinal Infections

Intervertebral disc infections occur in the spaces between adjacent vertebraes. This type of infection can be further divided into three subcategories:

  • Adult hematogenous - spontaneously occurring
  • Childhood (discitis) - inflammation that develops between the intervertebral discs of the spine
  • Postoperative – caused by bacteria or fungal exposure during surgery developing within 1-3 days post surgery

Vertebral osteomyelitis develops from direct open spinal trauma, which causes infections in the surrounding areas. The infections then pass bacteria from the surrounding area to the vulnerable vertebra via the blood supply.

Spinal epidural abscess is a soft-tissue spinal infection that grows around the dura (the tissue surrounding the spinal cord and the root of the spine). While this type of spinal infection can occur at any age, it is most common in people 50+ years of age.

Subdural abscess is much rarer, affecting the space between dura and arachnoid (thin spinal cord membrane, dura mater and pia material).

Infections within the spinal cord are called intramedulla parenchyma (main tissue).

Adjacent soft-tissue infections include cervical and thoracic paraspinal lesions and lumbar psoas muscle abscesses. Soft-tissue infections generally affect younger patients and are rarely seen in older people.

Causes of Spinal Infections

Bacteria or a fungal infection originates in another part of the body then travels into the spine through the bloodstream. The most common source of spinal infections is a bacterium called staphylococcus aureus often referred to as “staph,” followed by Escherichia coli or “E-coli.”

Urological procedure. Because the blood supply in the lower spine must travel through the pelvis, an infection could have traveled within — and infected — the lumbar region of the spine.

Symptoms of Spinal Infections

  • Fever
  • Chills
  • Headache
  • Neck stiffness
  • Pain
  • Wound
  • Redness
  • Tenderness
  • Wound drainage

Who’s At Risk For Spinal Infections?

  • Persons of advanced age
  • Intravenous drug users
  • Those living with Human Immunodeficiency Virus (HIV) infection
  • Long-term systemic usage of steroids
  • Diabetes mellitus
  • Organ transplantation
  • Malnutrition
  • Cancer
  • Surgical risk factors

How Do I Know It’s A Spinal Infection?

Physicians will use one or more of several diagnostic tools to identify the location of infection, and to determine the best course of treatment for you whether surgical or a non-surgical alternative.

Laboratory Tests

Blood tests to identify acute-phase proteins, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. Both ESR and CRP tests are often good indicators as to whether any inflammation is present in the body.

Imaging Tools

Imaging studies determine the location and extent of an infection. The choice of specific imaging techniques varies slightly, depending on the location of the infection.

Computed Tomography Scan (CT Scan)

To properly make a bone destruction diagnosis, a CT scan is required. By assessing the degree of bone destruction, the amount of spinal instability can be determined. This can also aid in deciding between non-surgical and surgical treatment options.

Don’t Delay! Seek Medical Care For Your Spine

Don’t delay in care for your spine. Early intervention is always recommended. Once the symptoms and spinal pain become unbearable, the infection has furthered and more complicated measures may result.

Sources:
www.spine.org
cdc
www.nindsnih.gov

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