Discitis is a Spinal Disc Infection and Inflammation

Early diagnosis and treatment is key to managing discitis

Discitis is usually caused by an infection in the disc and/or disc space between two vertebral bodies, and affects the intervertebral disc. Discitis is most often a bacterial infection but may be viral. In the United States, one out of every 100,000 people will develop discitis, so it is a relatively uncommon condition.

discitis infection in the lumbar (low back) spineThis disease can occur in both adults and children, but discitis is more common in children. You can learn more about how this infection may affect kids in How Discitis Affects Children.

Discitis most often occurs in the lumbar (low back) region of the spine, followed by the cervical (neck) spine, and then in the thoracic (mid-back) spine. Discitis often accompanies vertebral osteomyelitis, and they share many of the same characteristics. Although discitis and vertebral osteomyelitis are rare conditions, they can produce severe symptoms and affect your quality of life. That’s why diagnosis and treatment as early as possible are so important.

Causes of Discitis
There are two recognized causes of discitis. The rarer of the two causes is from a previous surgical or diagnostic procedure (when a needle or other device transfers the infection). The other cause—which is much more common—is known as spontaneous discitis. This means the infection developed from a bacterial or viral organism that traveled to the disc by blood from another area of your body.

When the infection begins elsewhere and travels to the disc, it is called transient bacteremia. Ear infections and skin infections are two examples of infections that could lead to transient bacteremia and possibly discitis.

Once a disc becomes infected, it's difficult for the body to fight the infection. The disc is the largest avascular organ in the body, meaning it lacks its own blood supply. That's why the discs have to get their nutrition and blood supply—including white blood cells to fight infection—from diffusion through the vertebral end plates. Because discs essentially use a third party to fight infection as opposed to having the resources to do so themselves, they have a harder time warding off infection.

Because discitis is typically caused by infections that first developed elsewhere in the body, people with certain medical conditions are at higher risk for developing discitis. These conditions include diabetes, AIDS, cancer, and chronic kidney disease.

Symptoms of Discitis
Severe back pain that begins gradually is the hallmark symptom of discitis. The pain is typically localized to the region where the infected disc is—so the pain won’t typically radiate down the neck or down the leg like some types of back pain conditions.

Diagnosing Discitis
Your doctor will go over your medical history and symptoms with you. Fever usually is not present once the infection is localized in the disc, and most times the white blood cell count is normal. However, the erythrocyte sedimentation rate is usually increased. The erythrocyte sedimentation rate is a specific test that looks at how fast red blood cells fall to the bottom of a tube. The faster they fall, the more likely it is there's inflammation somewhere in the body.

Though blood tests may be considered during diagnosis, the most accurate and commonly used diagnostic tool to confirm discitis is magnetic resonance imaging (MRI), which will show an infection if it exists.

Treating Discitis
Treating discitis can be a challenge, given how discs don’t have a good blood supply, and antibiotics travel via the bloodstream. Discitis is treatable, though, and it’s typically done so with a six- to eight-week course of antibiotics given intravenously (IV). Administration of an IV antibiotic may require the patient to receive treatment on an outpatient basis. Completing the entire course of antibiotic therapy is paramount to managing discitis.

Some patients are prescribed a brace to help stabilize the spine and reduce pain. Although the brace will limits movement, it can help ensure you properly heal.

Updated on: 02/23/17
Continue Reading
Infections of the Spine
Continue Reading:

Infections of the Spine

Certain factors increase your risk of developing spinal infections. Risk factors include, smoking, obesity, diabetes, and arthritis.
Read More