The spinal bones, discs and the internal epidural space can become infected.
This invariably requires prompt and effective treatment. Infections can be due to numerous micro-organisms including bacteria and fungi. Tuberculosis can also cause significant spinal infections.
Spinal infections may occur following surgery. Spinal infection can also occur and develop spontaneously.
Patients with general risks of systemic infection tend to be more prone to these types of infection, including Chronic infection, Immunosuppression, cancer, diabetes and renal dialysis.
Symptoms may include high temperature, pain, tenderness, and nerve symptoms in the limbs or spinal cord dysfunction in more advanced cases. In postoperative patients, increasing wound pain/tenderness, swelling, and discharge point to the possibility of postoperative wound infection.
Multimodality imaging, laboratory blood tests and microbiological examination and culture.
The mainstay of treatment includes antimicrobial medication, usually antibiotics, often given Intravenously in the first instance. Depending upon numerous factors, antimicrobial medication may be required for a prolonged period of time.
Surgery maybe advisable to assist in fighting the infection - debridement and washout.
Diagnostic samples taken at the time of surgery can often be instrumental in determining the most appropriate antibiotic medication. Surgery may be needed to reduce the pressure on the spinal cord or nerves. If the infection has resulted in significant spinal instability then there are often strong arguments for spinal stabilization surgery.
Surgery is not always required and image guided biopsies can be utilized to provide microbiology samples for the laboratory in these cases.
