Spine Infections

Spine Infections

Spine is a very sensitive area that can get infected by fungal organism, bacteria or after surgery (post-operative complication). Spinal infection can be classified according to the location and include the following :

  • Infection of Vertebral column is Vertebral osteomyelitis

  • Infection of Intervertebral disc space is Disc space infections can be divided into following three subcategories:

    • adult haematogenous (spontaneous),

    • childhood (discitis), and

    • postoperative

  • Spinal canal infections include:

    • spinal epidural abscess

    • subdural abscess

    • intramedullary abscesses

  • Adjacent soft tissues infections include:

  • Infection of Meninges is Meningitis

Risk factors of Spine infection

Any pre-existing condition that compromises the immune system will increase the chances of spine infection, such as:

  • Advanced age

  • Intravenous drug use

  • Long-term systemic use of steroids

  • Human immunodeficiency virus (HIV) infection

  • Diabetes mellitus

  • Obesity

  • Organ transplantation

  • Malnutrition

  • Cancer

In addition to the above mentioned factors that reduce patient’s immunity, following surgical risk factors also increases the chances of spine infection:

  • Long duration of surgical procedure

  • Excessive blood loss during or after surgery

  • Use of unsterilized instruments

  • Multiple or revision surgeries at the same site

Causes of Spine infection

Spinal infections can be caused by any of the following:

  • Bacterial (Staphylococcus aureusEscherichia coli etc.) or a fungal infection in spine itself or carried into the spine from other body part through the bloodstream

  • Urological procedure

  • Spinal trauma

Symptoms of Spine infection

Symptoms of spinal infection depend upon the type and location of infection and may include any of the following:

  • Localized pain at the site of infection

  • Fever

  • Headache

  • Chills

  • Weight loss

  • Stiffness in the neck

  • Wound drainage

  • Redness, swelling and tenderness at the incision site

  • Neurological symptoms

Some may even experience numbness, weakness, and tingling sensations in the arms or legs. The symptoms can be very severe or mild in different cases.

Diagnosis of Spine infection

Any patient with symptoms of spinal infection should be dealt promptly as it may sometimes take a month to appropriately diagnose the infection. Diagnosis starts with thorough physical and neurological examination followed by following diagnostic tests:

  • X-ray

  • CT scan

  • CAT scan

  • MRI

  • MRI with Gd enhancement

  • Blood test for acute-phase proteins, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels

  • Computed tomography-guided biopsy sampling of the vertebra or disc space to identify causative organism

  • Blood cultures, preferably taken during a fever spike

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