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Spinal infections occur between your vertebrae, including spinal discs. If left undiagnosed and untreated quickly, this could lead to severe back pain, fever, loss of appetite, and decrease in spine function.
Your doctor can diagnose a spine infection through imaging and lab work. Beginning with X-rays to evaluate disc wear-and-tear damage or bone erosion, and moving on to more detailed assessment techniques like an MRI for soft tissue health evaluation and bone integrity assessment.
Infection in Spine Symptoms
Symptoms vary based on the infection type, but typically manifest as localized pain. Common symptoms include:
– Severe back pain with fever and local tenderness.
– Radiating nerve root pain from the infected area.
– Weakness in voluntary muscles and bowel function.
– Wound drainage, redness, swelling, or tenderness near the incision.
– Fever, chills, and weight loss.
– Muscle spasms and painful or difficult urination.
– Neurological deficits like arm/leg weakness, numbness, or incontinence.
If suspecting a spinal infection, seek immediate medical attention. Early diagnosis and treatment are vital to prevent progression and potential damage to the backbone and surrounding structures.
Pain
An infection of the spine is a potentially life-threatening situation that should be taken seriously and treated immediately to reduce risk. Left untreated, it could result in decreased spinal function, spinal instability and neurological damage (even paraplegia) if untreated.
Spinal infections typically spread to the spine through bloodstream from another part of the body, typically through Staphylococcus aureus or Escherichia coli bacteria.
At the early stages of a spine infection, doctors will usually take x-rays to detect any bone deterioration caused by infection; an MRI test provides more specific diagnostic information by detecting soft tissue damage or disc enlargement that might also indicate infection. A needle biopsy may be performed if necessary to verify whether pathogens exist in the area.
Swelling
Spine infections typically result from bacterial or fungal infections in another part of the body that travel through the bloodstream to affect cervical, thoracic, or lumbar spinal regions. When left untreated, spine infections often spread to neurological impairment and break down bones forming an arched back posture known as Kyphosis.
Spine infections can be difficult to identify due to symptoms that mimic other pathologies, including back pain, herniated discs or muscle strains.
Accurate diagnosis requires conducting a comprehensive history and physical exam as well as bloodwork analysis and imaging analysis of the spine to identify any offending microorganisms and develop an antibiotic treatment plan accordingly.
Numbness
Numbness caused by spine infections usually arises slowly. It may affect either one side of your body or all along its entire spine.
Doctors usually begin diagnosing spinal infections by reviewing their patient’s medical history and conducting a physical exam, inquiring into when symptoms appeared and asking which were present before making a final determination.
X-rays, CT scans or an MRI can reveal the location and severity of a spine infection as well as any bone damage.
Not only can these imaging tests pinpoint where an infection exists; they also help doctors distinguish the type of infection the patient may be suffering from – for instance a spine infection caused by bacteria may begin in an intervertebral disc space, vertebral bone or spinal canal – while infections beginning at an endplate can quickly spread to other parts of the spine and even lead to spinal cord abscess – potentially serious and life-threatening conditions that require medical intervention to treat.
Fever
Fever is one of the key indicators of spinal infection. Additionally, patients may experience chills, nighttime pain or unexplained weight loss.
Fever is the body’s way of fighting an infection and seeking medical assistance if any symptoms of spine infection arise are essential.
Bacterial infections are the leading cause of spine infections, although fungus infections may occasionally also play a part. These infections can either be hematogenous (which spread from another area of the body) or local (related to surgery) with the latter more serious due to potential paralysis and death resulting in prolonged surgery cases or immunosuppressed individuals such as IV drug users or those receiving prolonged chemotherapy treatments.
Loss of Appetite
Spinal infections often accompany inflammation, leading to reduced body absorption of essential nutrients and thus leading to loss of appetite.
If your doctor suspects you of having a spine infection, they will most likely conduct lab work and imaging tests to pinpoint its source. They may check for elevated levels of inflammation such as ESR or C-reactive protein which are markers for infection.
Spinal infections often take several months or longer to be diagnosed, but if any of the following symptoms appear, medical attention should be sought immediately in order to stop further spread to the brain, spinal cord and surrounding soft tissue – which could result in severe complications.
How Is a Spinal Infection Diagnosed and Treated
The diagnosis of a spinal infection typically involves using imaging studies and laboratory tests. The preferred diagnostic procedure is magnetic resonance imaging (MRI) with gadolinium, followed by computed tomography (CT) with myelography.
To identify the causative organism and determine the appropriate antibiotic treatment, it is necessary to conduct blood cultures and cultures of specimens collected from the site of infection.
The treatment approach for spinal infections typically combines medical and surgical interventions. Non-surgical methods often involve long-term intravenous administration of antibiotics or antifungal medications, along with immobilization and rest. However, in cases of severe infection, spinal instability, or neurological deficits, surgical intervention may be necessary.
The preferred surgical treatment is anterior radical debridement followed by autologous strut bone grafting. It’s worth noting that the duration of antibiotic treatment for spinal infections tends to be longer compared to other types of infections, although the optimal duration remains unknown.
The treatment of spinal infections typically involves a multidisciplinary team consisting of infectious disease specialists, neurosurgeons, and orthopedic surgeons. If you suspect that you have a spinal infection, seeking immediate medical attention is crucial.
Early diagnosis and prompt treatment can help prevent the infection from progressing and minimize the extent of intervention required. Failure to seek timely care may lead to irreversible damage to your spine and surrounding areas.
What Are the Risk Factors for Developing a Spinal Infection
Multiple factors can heighten the risk of a spinal infection:
- Immune-compromising conditions: advanced age, HIV infection, diabetes, cancer, malnutrition, prior organ transplant, or immunosuppressant medication use.
- Intravenous drug use.
- Smoking.
- Obesity.
- Hemodialysis or renal failure.
- Surgical risk factors: lengthy surgeries, substantial blood loss, implantation of instrumentation, and multiple or revision surgeries at the same site.
- Urological procedures.
- Spinal trauma.
It is essential to acknowledge that 30-70% of patients with vertebral osteomyelitis show no apparent prior infection. If suspecting a spinal infection, seeking immediate medical attention is crucial. Early diagnosis and treatment can halt infection progression and potentially reduce the required intervention. Delaying care might lead to irrevocable damage to the backbone and surrounding areas.
Can a Spinal Infection Lead To Permanent Damage or Paralysis?
Yes, if left untreated, a spinal infection can lead to permanent damage or paralysis. The infection may compress the spinal cord, resulting in severe, irreversible paralysis and nerve impairment. Paralysis occurs in 4-22% of spinal epidural abscess cases, with initial misdiagnosis in about half of the patients.
Inadequate drainage of the abscess can lead to its recurrence or spinal cord scarring. Prompt medical attention is crucial to avoid irreversible damage to the backbone and surrounding areas.
Seeking immediate care upon suspicion of a spinal infection allows for early diagnosis and treatment, potentially limiting the required intervention.
