Definition and Overview

Osteomyelitis of the spine is a rare condition caused by an infection in the vertebral column. The infection can spread to the spinal canal through the bloodstream. It is often caused by bacteria or fungi. It causes weakness because it damages the spinal structure. It can also place undue pressure on the spinal cord or the nerves within and around it.

The condition can be acute or chronic. Acute cases often develop when bacteria from other parts of the body spread through the bloodstream. Chronic cases, on the other hand, may develop slowly as a result of certain infections. These include AIDS and tuberculosis. Disorders or diseases caused by a compromised or weak immune system can also cause the condition. The prognosis of patients with osteomyelitis depends on a number of factors. These include the concentration of the infection, how soon the treatment was started, and the treatment method used.

Key Symptoms

The condition often develops very slowly. It has very few symptoms. These may start with localised soreness and tenderness in the back and neck areas. As it progresses, patients may experience back pain and muscle spasms that get worse with movement. Other symptoms include swelling, redness, and inflammation of the spinal area. The list also includes fever, chills, and unexplained weight loss.

It is important for the condition to be treated as soon as possible. When left untreated, or if treatment is delayed, the infection can spread. This can cause paralysis.

In cases that result from spinal surgery, the onset of symptoms is usually delayed. They often start to show several days or a few weeks after surgery.

Causes of Condition

Common causes of the condition are the following:

  • Bacterial infection - Most cases are linked to certain bacteria. The infection often occurs in the lumbar spine where there is blood supply. The infection may result from a urinary bladder infection or pelvic infection. It can also result from pneumonia and other infections that affect the internal soft tissues.

  • Immune system conditions - Patients with a weak immune system have an increased risk of the condition. These include those who have cancer, AIDS, and diabetes. Those with drug abuse problem and have had an organ transplant are also included in the list.

  • Other types of infection - The condition can also be caused by infections that result from surgery as a form of complication. Infections from drug use and tuberculosis can also cause the condition to occur.

  • Long-term use of steroids

Who to See and Treatment Available

Patients with symptoms listed above must consult a doctor right away. Mortality rates for vertebral osteomyelitis can be high, especially when caused by bacteria. However, when diagnosed and treated promptly, the outcomes are relatively good. The chances of complete recovery and full restoration of spinal mobility are very high.

Tests and procedures used to diagnose the condition are the following:

  • Blood tests - These are used to determine the infection and inflammation levels.

  • Blood cultures - Used to identify the bacteria that caused the infection.

  • Radiological tests - These are subsequently required to confirm the results of initial tests. These include an x-ray, which determines the location of the infection. It is also used to check for disc compression or degeneration. A CT scan and an MRI are also used to evaluate infection in soft tissues in the spine. A nuclear bone scan may also be used to determine the extent of the infection.

  • Biopsy - This is used if there is an abscess. It involves collecting a sample of the abscess for further study.

Depending on the site of the infection and its extent, available treatment methods may include:

  • Medications - The condition is often treated with medications first. Patients are placed on antibiotic therapy for up to eight weeks. They are also prescribed with pain relievers. If the condition does not respond well to medications, doctors will consider surgery.

  • Surgery - Surgery is considered when the spine has been deformed, or in cases of neurologic failure. Surgery is used to remove the infected tissue or bone and reconstruct the spine. It may also involve draining or removing the abscess.

  • Spinal stabilisation - This may be necessary if the spine has been damaged. It may involve the use of medical devices to stabilise the spine.

  • Spinal fusion - This procedure can be considered if the spine is unstable. Its goal is to restore the damaged parts of the spine. Bone grafts may be harvested from another region of the body or from a bone bank. The bone graft is then attached to the affected spinal area to restore movement of the spine.

  • Bracing - This is often used along with antibiotic treatment to improve spine stability. It also helps lessen the pain and improve spine posture while recovering from the condition.

References:

  • Sasso, Rick C., MD., “Vertebral Osteomyelitis: Rare Spinal Infection Can Cause Severe Back Pain” (n.d.). Vertical Health, LLC. Retrieved 5 December 2017, from https://www.spineuniverse.com/conditions/spinal-disorders/vertebral-osteomyelitis-rare-spinal-infection-can-cause-severe-back-pain

  • “Spinal Infections (n.d.)”. Virginia Spine Institute. Retrieved 5 December 2017, from https://www.spinemd.com/symptoms-conditions/spinal-infections

  • Vaccaro, Alexander MD and Schroeder, Gregory. “Osteomyelitis, a Spinal Infection” (7 June 2015). Veritas Health. Retrieved 5 December 2017, from https://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-a-spinal-infection

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