Spondylodiscitis is a combination of

discitis Discitis, or diskitis, is an infection in the intervertebral disc space that affects different age groups. Symptoms include severe back pain, leading to lack of mobility. In adults, it can lead to severe consequences, such as sepsis or epidural ...

(

inflammation Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...

of one or more intervertebral disc spaces) and spondylitis (inflammation of one or more

vertebrae Each vertebra (: vertebrae) is an irregular bone with a complex structure composed of bone and some hyaline cartilage, that make up the vertebral column or spine, of vertebrates. The proportions of the vertebrae differ according to their spinal ...

), the latter generally involving the areas adjacent to the intervertebral disc space.

Causes

Spondylodiscitis is the most common complication of

sepsis Sepsis is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage of sepsis is followed by suppression of the immune system. Common signs and s ...

or local infection, usually in the form of an abscess. The main causative organisms are staphylococci, but potential organisms include a large number of bacteria, fungi, zoonoses. Spondylodiscitis frequently develops in

immunocompromised Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affe ...

individuals, such as by a cancer, infection, or by immunosuppressive drugs used for organ transplantations.

Diagnosis

The main methods to diagnose a spondylodiscitis are

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...

(MRI), biopsy and microbiological tests such as PCR to determine an infectious cause.

Treatment

Approximately 90% of cases can be treated conservatively. In the absence of spinal cord/nerve root compression and lack of data on instability of the inflamed segment, conservative treatment with: * Antibiotics - empirical treatment should start AFTER biopsy material for microbiological testing is obtained (PMID 27082590). The following empirical treatment may be administered for a total of 6 weeks (PMID 26872859): - Ceftriaxone 2x2g and Clindamycin 3x600mg i.v. for 2 weeks - Ciprofloxacin 2x500mg and Clindamycin 4x300mg p.o. for 4 more weeks If the pathogen can be identified - antibiotic treatment should be adapted to the susceptibilities of the microorganism. * Bed rest

References

External links

{{Dorsopathies Vertebral column disorders