Vertebral osteomyelitis

Vertebral osteomyelitis (also termed spinal osteomyelitis, spondylodiskitis, or disk-space infection), is a type of osteomyelitis (which is infection and inflammation of the bone and bone marrow). Vertebral osteomyelitis is a rare bone infection concentrated in the spinal region. Cases of vertebral osteomyelitis are so rare that only 2-4% of all bone infections are attributed to the disease. The infection can be classified as acute or chronic depending on the severity of the onset of the case, where acute patients often experience better outcomes than those living with the chronic symptoms that are characteristic of the disease. Although vertebral osteomyelitis is found in patients across a wide range of ages, the infection is commonly reported in young children and older adults. Vertebral osteomyelitis often attacks two vertebrae and the corresponding intervertebral disk, causing narrowing of the disc space between the vertebrae. The prognosis for the disease is dependent on where the infection is concentrated in the spine, the time between initial onset and treatment, and what approach is used to treat the disease.

The disease is known for its subtle onset in patients, and few symptoms characterize vertebral osteomyelitis. Correct diagnosis of the disease is often delayed for an average of six to twelve weeks due to such vague, ambiguous symptoms.

General symptoms found in a cross-section of patients with vertebral osteomyelitis include fever, swelling at the infection site, weakness of the vertebral column and surrounding muscles, episodes of night sweats, and difficulty transitioning from a standing to a sitting position. Additionally, persistent back pain and muscle spasms may become so debilitating that they confine the patient to a sedentary state, where even slight movement or jolting of the body results in excruciating pain. In children, the presence of vertebral osteomyelitis can be signaled by these symptoms, along with high-grade fevers and an increase in the body's leukocyte count.

Patients with an advanced case may present some or none of the symptoms associated with general cases of vertebral osteomyelitis. When the osteomyelitis is isolated in the back, as it is in vertebral osteomyelitis, the patient will report muscle spasms coming from the back, but may not report experiencing any fevers. Symptomatic signs vary in each patient and depend on the severity of the case. Neurologic deficiency characterizes advanced, threatening cases of the disease. On average, 40% of patients with an advanced case of vertebral osteomyelitis experience some type of neurological deficiency; this is a sign that the infection has been progressing for some time. In advanced cases, the untreated infection will attack the nervous system through the spinal cord which runs parallel to the vertebral column, placing the patient at risk for paralysis of the extremities. Additionally, loss of the ability to move is a trademark symptom of neurologic problems in advanced cases of vertebral osteomyelitis. Any further signs of neurological deficit signal an advanced case of vertebral osteomyelitis that requires immediate intervention to prevent further threat to the spinal cord.

...
Wikipedia