There are three varieties of spinal infection that allow us to define this back pathology:
-Discitis: Intervertebral disc infection.
-Spondylitis (osteomyelitis): Infection of the vertebra.
-Spondylodiscitis: Infection of the spine that affects the vertebra and intervertebral disc.
Which are the causes?
Bacteria, fungi and parasites. Generally, there is a history of infection in other areas of the body (genitourinary, skin, respiratory tract) that, through the blood gets into the vertebra or intervertebral disc.
One of the most frequent reasons for infections in the vertebrae or intervertebral disc is post-surgery, after performing open surgery of the spine. In this case, the lesion is more favoured in immunosuppressed patients (an immune system that works below the normality index). But also in diabetics, chronic pathologies, obesity, smokers, anaemic or malnourished, and when doctors perform long-term surgeries. It can be an infection in superficial planes that causes an opening of the surgical wound, or it can infect deep planes with the involvement of the muscles, fascia, ligaments, vertebrae and intervertebral disc.
Other causes may be wounds near the spine or penetration of foreign bodies contaminated to these structures.
Signs of spinal infection
The patient suffers pain in the area of the back or region of the affected spine and fever if it is an acute process.
If the germs have reached through another infected organ such as the skin, the urinary or the respiratory system, the patient will also have the symptoms of affection in the vertebrae.
Any infectious condition involves apathy and malaise, in addition to fever. However, the fundamental symptom of the involvement of the vertebrae by infection of a germ is pain focused on the part of the affected back.
If the infection increases in the vertebral body or in the intervertebral disc, greater weakening of these can occur. It leads to necrosis and vertebral crushing. The progression of the pathology to the layers that cover the spinal cord or peripheral nerves can cause neurological alterations.
When there is an infected surgical wound, its edges often open and a serous and purulent spotting occurs through that wound (serum and pus). This infection can penetrate deep planes and increasingly affect more perivertebral structures with increased pain.
The diagnosis of these pathologies is difficult in case of infection through the blood (hematogenous dissemination). It involves differential analysis with inflammatory, degenerative or tumour diseases. To diagnose the processes of vertebral infection and differentiation with other diseases, doctors usually require:
-CT and RM.
-Sampling for culture by puncturing or directly from the affected bed, including soft tissue and infected bone.