Spinal Infection

Description

Mr Nick Birch gives his expert insights and discusses how spinal infections, although infrequent, their management is critical due to potentially severe consequences. Key infection sites include the disc (discitis), vertebral body (spondylitis), epidural space (paraspinal abscess), and a combination of disc and vertebral body (spondylodiscitis). Bacterial infections, chiefly from Staphylococcus aureus or tuberculosis, are common, with a lesser incidence of fungal infections, particularly in occupational settings.



At heightened risk are the elderly, malnourished, and immunocompromised individuals, including those with diabetes or HIV. Symptoms typically feature back pain, fever, and sometimes neurological deficits, particularly with abscess formations. Diagnosis relies on laboratory tests showing inflammation and imaging, like MRI, which reveals affected areas.



Management primarily involves antibiotic therapy tailored to microbiological results and may necessitate surgery for neurological deficits, cord compression, or extensive bone destruction due to infection. Complications may include worsening neurological outcomes, instability, and systemic conditions like sepsis. Preventative measures emphasize sterile techniques during surgeries and prompt attention to suspected infections.




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DOI: 10.1302/3114-251111

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