Discitis is a Spinal Disc Infection and Inflammation

Discitis is usually caused by an infection that develops in one of the spine’s vertebral bones and/or intervertebral discs. Often, discitis is a bacterial infection, but it may be viral. In the United States, the incidence of discitis is approximately 1 out of every 100,000 people, meaning it is not a common spinal disease.

discitis infection in the lumbar (low back) spineDiscitis is an uncommon spinal condition affecting approximately 1 out of every 100,000 people in the United States.This 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 youngsters 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 both types of spinal infections share many of the same characteristics. Although discitis and vertebral osteomyelitis are uncommon 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.

What causes discitis?
There are 2 recognized causes of discitis. The rarer of the 2 causes is from a previous surgical or diagnostic procedure (when a needle or other device transfers the infection). The other cause—which is 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 the body.

When the infection begins elsewhere and travels to the disc, it is called transient bacteremia (short-lived bacteria in the blood stream). Ear infections and skin infections are 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 don’t have the resources to fight infections by themselves, they struggle to protect against 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.

What are the 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.

How does a doctor diagnose 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 examines 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.

How is discitis treated?
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 6- to 8-week course of antibiotics given intravenously (IV). Administration of an IV antibiotic may require you to receive treatment on an outpatient basis. Completing the entire course of antibiotic therapy is paramount to managing discitis.

You may also be prescribed a spinal brace to help stabilize your spine and reduce pain. Although the brace will limit your movement, it can help ensure you properly heal.

Updated on: 08/06/19
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Infections of the Spine
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Infections of the Spine

Learn about the most common spinal infections, spinal infection symptoms and risk factors, and diagnosing and treating spinal infections.
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