Infections of the Spine
Spinal infections may arise spontaneously or as a secondary condition, such as after an invasive medical procedure. Infections in the spine may affect different structures, such as the vertebral column (spinal bones), intervertebral disc space (the cushion-like structures between the vertebrae), and the spinal canal.
Below are some facts about incidence and prevalence of various spinal infections:
- Vertebral osteomyelitis, the most common type of vertebral infection, affects an estimated 26,170 to 65,400 people each year.1
- Epidural abscess, an infection in the spinal canal, impacts up to two cases per every 10,000 hospital admissions in the U.S. However, epidural abscess is quite common in patients with vertebral osteomyelitis or discitis—up to 18 percent of those people may develop this type of infection. Epidural abscess is most common in people age 50 and older.1
- One out of every 100,000 people in the U.S. will develop discitis. It is a relatively uncommon condition.
- Despite treatment advances, an estimated 20 percent of people who have spinal infection die from it.1
- Immunosuppression (either from acquired immunodeficiency syndrome or medical treatment for tumors)
- Organ transplantation
- Drug addiction
- Recent urinary tract instrumentation
Spinal Infection Symptoms and Diagnosis
Spinal infection symptoms vary, but constant back pain without a history of trauma is cause for concern. Often, there is a delay in diagnosing a spinal infection because of the subtle presentation, the failure to take pain seriously, and the absence of body-wide signs, such as fever.
Also complicating the diagnostic process is that lab results may be misleading, as normal white blood cell counts are common, x-rays often show no abnormalities early on, and even more sensitive diagnostic tests (eg, bone scan) may not become positive for a week.
An elevated erythrocyte sedimentation rate is a valuable screening test. Erythrocyte sedimentation rate is a lab test that measures the rate at which red blood cells settle in a test tube. The test can measure inflammation and/or infection in the body.
When a spinal infection is suspected, magnetic resonance imaging (MRI) may be the most reliable tool to confirm the diagnosis early.
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