A spine comprises of vertebral column, dural sac, and invertebral discs and any of them infected would rise to spinal infection. This infection may be cause by some fungal organisms or bacteria.
Spinal infections might happen after surgery or with patients who have high chances of or easily gets infected. Factors that can easily get you spinal infections are diabetes, cancer, obesity, Human Immunodeficiency Virus (HIV), immune suppression and poor nutrition.
Figures shows that in spite of all preventive measures taken, still up to 4% of surgical cases have experience complication like infection. The probability of such infection rises with the number of surgery done. Post operative infections also happen and it is not likely to surface between 3 to 90 days after the surgery.
Signs of Spinal Infection
Signs of spinal infection include tenderness and wound redness; wound drainage, pain, stiffness in the neck, headache, chills, and fever. In rare cases patients may complain of weakness, tingling or numbness feeling in the legs and or arms. Symptoms may vary from mild to severe.
Diagnosis for Spinal Infection
To identify the presence of spinal infection, your doctor should start with your symptoms as well as your medical history. Your doctor will most likely ask you questions to screen you for spinal infection risk factors. A series of test may be required like X-ray, CT Scans or MRI Scans. In some instances, if doctors are not yet sure then a more advance testing is needed. This testing includes nuclear medicine tagged white blood cells scans and nuclear medicine bone scans.
Several cultures are also needed to know the kind of fungus or bacteria which cause the infection. The most common is blood cultures to check for any evidence of infection. For severe infection in the vertebrae or in the disc, a needle culture may be needed. Additional blood test like erythrocyte sedimentation rate (ESR), c-reactive protein (CRP) and white blood cell (WBC) count. Abnormal raise in the results of this testing are a sign of infection.
Treatment of Spinal Infection
Treatment for spinal infection includes anti-fungal medications or anti biotic. Duration of such treatment depends on how severe the infection is and what kind or organism causes the infection. Medications may be taken orally or through intravenous (IV). Duration of treatment may range from seven to ten days or six to twelve weeks. Doctor may recommend the use of brace to support the spine till it heals as well as to help ease the pain.
Surgery is necessary to wash away the infected tissue as well as the bacteria. Also surgery may be necessary if there is a proof of spine instability associated to infection. In instances where severe weakness has developed because of spinal infection then surgery might be needed to ease the pressure in the spinal cord which is cause by the infection.
Long term treatment for such condition may consists of surgery and antibiotics to treat the spinal infection completely. During this treatment the following test results – WBC count, CRP count and ESR count will be closely monitored by your doctor. If the values are not normal even after the surgery then that means there is still an infection and it may still recur in the future.
However in a recent study, surgeons found out that spinal infection after surgery is less with minimal invasive spinal surgery against the traditional open surgery. Indeed this is great news for those candidates for spine surgery ( Journal of Neurosurgery: Spine. 2009)