What Is Spondylodiscitis?
Spondylodiscitis or infectious spondylitis and infective spondylitis refers to an infection involving the intervertebral disc and the vertebral bodies near it. The spondylodiscitis meaning involves the combination of two Latin words, namely “spondylo” for the vertebrae and “discitis” for inflammation of the disc, thus representing a disease condition affecting both of these simultaneously. This disease is not to be confused with spondylosis, which is simply aging damage to the spine as opposed to an infection, nor with mechanical back pain, which lacks an infectious etiology altogether. Infective spondylodiscitis occurs when microorganisms including bacteria, tubercular infection, or, on rarer occasions, fungi enter the spine via the bloodstream, the spread of an existing infection, or surgery on the spine. Given that it is caused by infection rather than mere wear and tear, early detection is critical.
Spondylodiscitis Symptoms
Infectious spondylitis symptoms usually progress gradually and thus can result in a delayed diagnosis. Backache or neck pain that is unresponsive to rest and that tends to increase at night is the main presenting symptom. Fever, shivering, and malaise are other systemic symptoms that could occur with the pain, especially when the infection is caused by bacteria; however, they are not always obvious or present when the causative agent is Mycobacterium tuberculosis. As the disease advances, there is increased localized tenderness, muscle spasm, and stiffness. When nerves get affected, numbness, weakness, and pain could be experienced.
Types of Spinal Infection
Pyogenic or Bacterial Infection
Pyogenic spondylodiscitis is the most common type and is bacterial in origin, usually traveling through the bloodstream from an infection elsewhere in the body. This form of the disease develops rapidly when compared with other forms.
Tuberculous Infection
Spinal tuberculosis includes an important etiology of spondylodiscitis, especially in those areas where tuberculosis is common. Spinal tuberculosis develops slower than a bacterial infection but causes more bone erosion when left untreated for a longer period of time.
Fungal and Post-Surgical Infection
Spondylodiscitis in fungi is relatively uncommon, usually affecting people with compromised immunity. Post-surgical spondylodiscitis may result from spinal surgeries due to introduction of the organism into the disc or vertebrae space during or after the surgical procedure.
What Causes Spondylodiscitis?
The types of infectious spondylitis causes can be described as follows: spread of bacteria or tuberculosis through the blood circulation system from another infection source within the body; spread of infection from an adjacent infected region; and spread of infection resulting from spinal surgery. The following conditions make patients more prone to the development of infectious spondylitis: diabetes mellitus, suppressed immunity, injection drug use, renal disease, and older age. It is important to determine the exact cause in order to define the right antibiotic or antifungal therapy.
Infectious spondylitis causes can be classified into some general groups. Infection that is spread via the bloodstream due to the presence of bacteria or tuberculosis infection from another part of the body, infection that spreads from adjacent areas, and post-operative infection fall under this category. Susceptibility to infection is increased by diabetes, weakened immunity, intravenous drug use, chronic renal failure, and old age. Identification of the causative agent in this case is highly significant since it will determine the treatment.
How Spondylodiscitis Is Diagnosed
Diagnosis usually involves the use of blood investigations, including inflammatory markers and blood cultures, together with imaging procedures such as MRI, which is very efficient in identifying infections within the disc and vertebrae as well as any presence of abscesses. In most instances, there is also a biopsy of the affected disc or bone that helps in identifying the causative agent, be it bacteria, tubercle, or fungus, since this enables a more precise antibiotic therapy instead of using wide-range antibiotic treatment. Discriminating between spondylodiscitis and degenerative disorders such as spondylosis is one of the key aspects of this process.
Spondylodiscitis Treatment
Antibiotic Treatment
Infectious spondylitis treatment involves the use of antibiotic or antifungal drugs for an extended period of time, which can last up to six to twelve weeks. The choice of antibiotics depends on the type of organism detected. This therapy may be guided by the results of the biopsy.
Surgery
Surgery is not always necessary; however, in cases where there is severe bone destruction, spinal instability, the need for an abscess drainage, and neurological involvement secondary to nerve or spinal cord compression, surgery is a must. This will involve spinal reconstruction surgery and even spinal fusion to restore stability to the affected spinal segment.
When to See a Spine Doctor
You need to visit a spine specialist immediately if you have back/neck pain along with a fever, which doesn’t get better even after resting, or weakness/numbness. Dr. Zahir Abbas Merchant from The Spine eXpert, who has more than 15 years of experience in the orthopedic field, stresses that one needs to get evaluated immediately if there is a suspicion of infection of the spine in Mumbai.
Frequently Asked Questions
Is spondylodiscitis serious?
Certainly, spinal infections should be viewed seriously all the time because when they are not treated on time, they could cause destruction of bones in the spine, spinal instability, or nerve injury.
How long is the treatment for spinal infection?
The treatment usually lasts between six and twelve weeks of antibiotics or antifungals, but for tuberculosis or situations that involve surgical procedures, treatment time is extended.
Does spondylodiscitis always need surgery?
Of course not; most cases are treated effectively with the use of only antibiotics. Surgery, including spinal reconstruction or spinal fusion surgery, is only considered in case of instability, formation of an abscess, and nerve impingement. To get an accurate diagnosis, you can visit Dr. Zahir Abbas Merchant at The Spine eXpert Clinic.