Infection

heT

   The verterbal body is a favorite site of infection because of its good vascularity. Once infected its structural integrity can be affected causing it to collapse and compress on the sensitive spinal cord and roots.

      Just like any part of the body, the spine is very vulnerable to infection. Any structures in and around the spine can be infected.  The usual route is blood borne usually arising from another part of the body that is primarily infected.  The usual focus of infection is the vertebral body because it is a very vascular structure.  The earliest and most predominant symptom is pain. Fever may or may not be present. 

         Infection of the spine can be categorized  as acute or chronic.  The former is usually caused by pyogenic bacteria and the latter is usually caused by tuberculosis of the spine. The common denominator in spine infection is inflammation in and around the spine. This leads to the following signs and symptoms.
Pain           - is usually very severe and localized
                  to the infected level.  Patients have
                  a hard time finding a comfortable
                  position.  Simple body movements
                  create intense pain. Simply touching
                  the patient can elicit pain.

Weakness   - can be secondary to the general
                    constitutional symptoms of general
                    body malaise.  Medical evaluation
                    is needed to determine subtle signs
                    of weakness due to compression of
                    the spinal cord and nerve roots due
                    to accumulation of pus into the
                    spinal canal. 

Deformity   - deformity seldom occurs in infection
                   unless damage to the integrity of the
                   spine  anatomy  has  been  set  in.  
                   Acute  infection  seldom  causes 
                   deformity unless it is neglected.  It is
                   common  in  chronic tuberculosis  of 
                   spine  where  the  spine  anatomy
                   ​is slowly destroyed by the infection.
 
Cauda Equina Syndrome   - is a "surgical emergency."                      Patients would usually experience severe                      leg pains with sudden weakness of both                        lowers.  There would be an associated                          urinary or bowel incontinence.  This                              signifies severe cord compression that                          necessitates immediate decompressive                        surgery.
 
Paralysis    -deformity or cauda equina syndrome                            usually precluded paralysis. Paralysis
                   is a late sequela usually due to neglect
                   of immediate treatment.  It is usually                            caused by compression of pus into the                          spinal canal, cord compression due  to
                   collapse of anatomy  and vascular
                   injury  due  to the  intense inflammatory                        process involved  iinfections.

      Once a verterbal body is invaded by infection, it can spread by contiguity to adjacent structures.  Pus can dissect up and down between the planes of the bones and ligaments.  There can be multiple level of involvement if proper treatment is not instituted.  Infection can create space occupying lesions that can compress the cord or thrombose vital circulation to the neural structures. Immediate medical attention can prevent the spread of infection and destruction of too many structures.

        When considering infections of the spine basic serological exams are needed.  Imaging exams may also help in the diagnoses and the demarcation of the geographic extent of the infection.  Your spine specialists would normally order one or combination of all these labs to fully evaluate your spine and offer the best management.

               Blood exam -       Complete Blood Count

                                             Erythrocyte Sedimentation Rate

                                             C- Reactive Proteins


               Imaging                - X-Rays
                                             - CT Scans
                                             - MRI with contrast medium

Copyright UPMC Spine Specialists (2012) Manila, Philippines

No illustrations should be copied from this Website without the permission of the webmaster



ACKNOWLEDGEMENTS :



Many illustrations in this Web Page were borrowed from open source Netter Anatomical Illustrations and the Sobotta Atlas of Human Anatomy.  However most of the original borrowed illustrations may not be recognized anymore.  Most of them were digitally modified and altered to serve the purposes of discussions and explanations contained within this web.



Other illustrations are originally drawn by the Webmaster.



www.upmcspinespecialists.com









  • Wix Facebook page
  • Wix Twitter page
  • Wix Google+ page