Spinal Infection

Though infections of the spine are rare, if they are neglected for a period of time, or if there is a delay in diagnosis, they can become a significant source of pain and disability. Bone and joint infections anywhere in the body can be crippling and life threatening.

Symptoms

Slow onset of severe neck pain often traveling to other parts of the body including the abdomen, hip, leg, or groin; may or may not be associated with fever, chills, sweats, feeling tired, loss of appetite or other symptoms.

About this Condition

Though infections of the spine are rare, if they are neglected for a period of time, or if there is a delay in diagnosis, they can become a significant source of pain and disability. Bone and joint infections anywhere in the body can be crippling and life threatening.

Discitis is a low-grade infection that affects the disc space between two vertebrae. It is characterized by the slow onset of severe neck pain and may or may not be associated with fever, chills, sweats, feeling tired, loss of appetite or other symptoms. The diagnosis is usually made by seeing narrowing of the disc space between two vertebrae, a bone scan that shows that the disc and adjacent vertebrae are "hot" on the scan, or classic changes on MRI scans.

This condition can be very painful and is often aggravated by any movement of the spine. The pain may travel to other parts of the body including the abdomen, hip, leg, or groin. It usually occurs in the lower (lumbar) back and upper (thoracic) back. Young children with this condition are usually irritable and uncomfortable and refuse to sit up, stand or walk. The treatment of discitis generally involves antibiotics, rest, and a brace. Surgery is rarely needed.

 

 

This content is for your general education only. See your doctor for a professional diagnosis and to discuss an appropriate treatment plan.

Conservative Treatments

Medication and Pain Management

The goal when prescribing medications should be maximum reduction of pain and discomfort with minimal risk of overuse of the medications and avoiding side effects.

Non-steroidal anti-inflammatory medications (NSAIDs) include common over-the-counter drugs such as aspirin, ibuprofen and naproxen among others. These drugs are potent long-term pain reducers that work without concerns of dependence.

Opioid therapy to control chronic back pain is less ideal because of potential toxicity to the body and physical and psychological dependence. Treatment by this class of drugs should generally be a short term option when patients do not respond to alternatives.

Pain can often be reduced through the use of muscle relaxants, anti-seizure pain medications such as Neurontin, Topamax, and Lyrica, anti-depressants, and oral steroids.

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Bracing for a Spinal Infection

Bracing is used for 3-6 months following initiation of treatment for discitis, a spinal infection. Note that even with the use of appropriate antibiotics and bracing, collapse of the vertebral segments may occur.

Surgery

METRx Minimally Invasive Hemilaminectomy

A hemilaminectomy is a spine surgery that involves removing part of one of the two laiminae on a vertebra to relieve excess pressure on the spinal nerve(s) in the lumbar spine, or lower back. A hemilaminectomy can be performed to relieve symptoms such as back pain and radiating leg pain.  A METRx hemilamectomy is a minimally invasive procedure performed utilizing METRx technologies.

In a traditional open lumbar laminectomy the two laminae and spinous process of a vertebra are removed to relieve excess pressure on the spinal nerves in the spine. The term laminectomy is derived from the Latin words lamina (thin plate, sheet or layer), and -ectomy (removal). A laminectomy removes or “trims” the lamina (roof) of the vertebrae to create space for the nerves leaving the spine.

Anterior Cervical Discectomy with Fusion

Anterior cervical discectomy with fusion is an operation that involves relieving the pressure placed on nerve roots, the spinal cord or both by a herniated disc or bone spurs.

Through a small incision made in a natural deep skin crease in the front of the neck, the surgeon:

  • Removes the intervertebral disc to access the compressed neural structures
  • Places a bone graft to fuse adjacent vertebrae
  • In some cases, implants a small metal plate to stabilize the spine while it heals
  • In certain cases, an artificial disc may be placed

 

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Posterior Fusion

Following a discectomy, laminectomy or other surgery that involves removing portions of one or more vertebrae to relieve pressure on the spinal cord and nerves, fusion instrumentation and bone grafting are used to stabilize the spine. Metal or non-metal instrumentation is put in place to hold the vertebrae together as the bone graft grows and fuses the vertebrae. These implants include rods, plates and screws that are left in place after the surgery. Bone grafts may be placed on the outside of the two vertebrae or between the vertebrae (interbody).

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Please keep in mind that all treatments and outcomes are specific to the individual patient. Results may vary. Complications, such as infection, blood loss, and bowel or bladder problems are some of the potential adverse risks of surgery. Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results and other important medical information.