Infections involving the spinal canal are rare and include osteomyelitis, discitis, and epidural abscesses. Osteomyelitis refers to an infection of the vertebral bone of the spinal column caused by a bacteria or fungus. Discitis is an infection of disc between two vertebrae, occurs more commonly in children. Epidural abscess is a collection of pus between the dura, a membrane that covers the spinal cord and nerve root.
Osteomyelitis patients may experience fever and chills, severe back pain, weight loss, painful urination, and intolerance to light. Neurological symptoms may also be present if the disease progresses. Discitis patients develop severe back pain, and children may refuse to flex the spine. Patients with epidural abscess may develop a pins and needles sensation or mild weakness.
Spinal infections are caused by either a bacterial or fungal infection that is carried into the spine through blood stream. Certain risk factors for spinal infections include age, smoking, , poor nutrition, obesity, drug addiction compromised immune system, diabetes, and cancer.
Your doctor will diagnose spinal infections with physical examination and history. Additional tests may be ordered to look for an infection and may include plain X-rays, CT scan or MRI scan. Magnetic resonance imaging scan is the most reliable test to determine the presence and extent of infection and presence of spinal compression.
Blood cultures may be ordered to determine type of bacteria or fungus causing the infection. Additional blood tests such as a white blood cell (WBC) count, C – reactive protein (CRP) and an erythrocyte sedimentation rate (ESR) may be performed to screen for signs of an infection.
Treatment depends on the severity of the infection and the organism causing the infection.
Long-term intravenous antibiotic or antifungal therapy may be recommended. Bracing may be recommended to provide stability for the spine until healing occurs and help with pain.
Surgery may be necessary if the infection does not respond to antibiotic therapy. Surgery involves removal of infected tissue with stabilization of spine. Surgical technique is used to join together two bones in the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until new bone grows between them.