Spine Infection
Spinal infections can be categorized by their anatomical locations, such as the vertebral column, intervertebral disc space, spinal canal, and adjacent soft tissues. These infections can be caused by bacterial or fungal organisms and may develop after surgery. Early diagnosis and treatment are crucial to prevent irreversible damage and complications.
Types of Spinal Infections
Vertebral Osteomyelitis: Most common form affecting the vertebral bones, often resulting from trauma or bacterial spread from other areas.
Intervertebral Disc Space Infections: Infections between adjacent vertebrae, categorized into adult hematogenous, childhood discitis, and postoperative.
3. Spinal Canal Infections: Includes spinal epidural abscess and subdural abscess affecting the dura and arachnoid membranes, respectively.
4. Adjacent Soft-tissue Infections: Infections affecting cervical and thoracic paraspinal areas and lumbar psoas muscles, more common in younger patients.
Incidence and Prevalence
- Vertebral osteomyelitis affects 26,170 to 65,400 people annually.
- Epidural abscess is rare but can develop in 0.2 to 2 cases per 10,000 hospital admissions.
- The incidence of spinal infections may be increasing due to factors like increased use of vascular devices and intravenous drug abuse.
Risk Factors
Risk factors include advanced age, intravenous drug use, HIV infection, long-term steroid use, diabetes, organ transplantation, malnutrition, cancer, and certain surgical procedures.
Symptoms
Symptoms vary based on the infection type but commonly include localized pain, neurological deficits, fever, chills, and muscle spasms.
Diagnosis
Early diagnosis is challenging but crucial. Diagnostic methods include blood tests for inflammatory markers, CT-guided biopsy, blood cultures, and imaging studies like CT scans and MRIs.
Treatment
Nonsurgical Treatment: Involves long-term intravenous antibiotics or antifungal therapy, immobilization, and close monitoring.
Surgical Treatment: Considered when nonsurgical methods fail or when specific indications like significant bone destruction, neurological deficits, or sepsis are present. Surgical goals include debridement of infected tissue, restoration of spinal stability, and improvement of neurological function.
Follow-Up
Regular follow-up is essential to monitor treatment response and assess the need for further interventions. Multidisciplinary care involving infectious disease experts, neuroradiologists, and spine surgeons is often required for optimal management.
Seek immediate medical care if symptoms of a spinal infection, such as new neurological deficits or uncontrolled fever, develop. Early intervention can prevent complications and improve outcomes.
