While rare, infections of the spine are possible and can occur in the intervertebral disc of the spine (referred to as “discitis”) or the vertebral bones of the spine (referred to as “osteomyelitis”). These infections are often bacterial, traveling to the spine through the bloodstream. When a spinal infection occurs, the bone can begin to deteriorate and collapse upon itself.
Elderly patients, intravenous drug users and people with impaired or weakened immune systems are most at risk for developing spinal infections. Potential causes and contributing factors include:
- Post-surgical infections
- Poor nutrition
- History of organ transplant
- Steroid use
Spinal infections often result in a slow onset of symptoms, which can delay diagnosis. Early onset symptoms might include tenderness of the neck or back, which can be attributed to many other causes as well. Symptoms that follow may include:
- Pain that is worse with movement and doesn’t respond to rest and medication
- Neck stiffness
- Swelling or redness at the infection site
- Night pain
- Unexplained weight loss
- Bowel and bladder incontinence
- Progressive development of severe back pain with limited mobility
- Weakness, numbness or tingling in the arms and legs
It is important to note that these symptoms can vary widely between patients, and some spinal infection patients may not experience any severe symptoms at all until the condition is quite advanced.
If a spinal infection is suspected, imaging scans,such as computed tomography (CT) or magnetic resonance imaging (MRI), are typically ordered, often utilizing contrast dye to highlight the areas of damage. From there, your doctor may order blood cultures to verify diagnosis and confirm the type of bacteria or fungus contributing to the infection.
When a deep infection is suspected, your interventional neuroradiologist may use image guidance and a catheter to obtain a biopsy.
Standard treatment options for spinal infections include:
- Intravenous Antibiotic Medications: To kill the infection, antibiotics may be prescribed for anywhere from 7 to 10 days, to 6 to 12 weeks. A central line may need to be placed in order to assist in the administration of longer-term medications.
- Bracing and Rest: These treatments help to improve stability while the spine heals.
Unfortunately, because vertebral discs do not have a good blood supply, antibiotics will not always kill the infection. In these cases, or when nerve compression has occurred, surgical options may be necessary to treat the infection and repair the damage to the spine (or prevent further damage).