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Spondylodiscitis

What is Spondylodiscitis?

Spondylodiscitis is an infection of the intervertebral discs (between the vertebrae) along with the vertebrae (one of many small bones forming the spine). The condition is a primary infection of one or more intervertebral discs (discitis) with secondary infection of one or more vertebrae (spondylitis).

Spondylodiscitis is known to affect men more than women and the incidence is likely to increase with age.

Types of Spondylodiscitis

There are two types of Spondylodiscitis

  • Endogenous Spondylodiscitis: The infection begins in another part of the body and reaches the vertebrae through the blood.
  • Exogenous Spondylodiscitis: The infection (mostly bacterial) is caused by a surgical procedure or an injection to the vertebral column, and spreads throughout the vertebral system.

What Causes Spondylodiscitis?

Any type of infection that begins in the vertebral system or spreads to it from other parts of the body can cause spondylodiscitis. Medical conditions such as diabetes, or cardiac diseases may be associated with spondylodiscitis.

What are the Signs and Symptoms of Spondylodiscitis?

The most visible and common symptom is a medical condition called kyphosis (excessive outward curvature of the spine, causing stooping of the back).

Other likely symptoms include:

  • Severe back and neck pain
  • Neck pain which radiates to the chest or abdomen
  • Feeling of stress in the spinal column due to compression
  • Discomfort or pain while walking, especially in the heels
  • Pain while bending forward or straightening up
  • Weakness or loss of sensation in the legs
  • Fever and weight loss (although rare)

What If Spondylodiscitis is Left Untreated?

If left untreated, spondylodiscitis can lead to a serious medical condition called osteomyelitis (inflammation of bone or bone marrow).

How is the Condition Diagnosed?

Spondylodiscitis is a rare medical condition and may be difficult to diagnose. Some of the tests which can help to diagnose spondylodiscitis include:

  • X-rays
  • MRI and CT scan
  • Skeletal scintigraphy (bone scan using radioactive tracers)
  • Tissue biopsy along with a microbiological test

How is Spondylodiscitis Treated?

The treatment usually begins with conservative options. Primary treatment may be an extensive course of antibiotics followed by a course of spine immobilization. Physical therapy and anti-inflammatory medication may be recommended.

If conservative treatments do not provide adequate relief after six weeks, surgery may be needed to correct the condition. The surgical options include:

  • Spinal decompression with an autologous (your own) bone graft or a titanium cage
  • Human bone morphogenetic (normal form) protein
  • Percutaneous transpedicular discectomy (uses a needle to remove a disc)

If Spondylodiscitis is diagnosed early, the chances of a full recovery are high.

  • American Academy of Orthopaedic Surgeons - AAOS
  • AO Foundation
  • North American Spine Society
  • Lumbar Spine Research Society
  • Orthopaedic Research Society