SPINAL INFECTIONS

Infections of the spine can affect the surrounding soft tissues, intervertebral discs, or vertebrae. They could develop following surgery or trauma, or they could spread through the bloodstream. In order to avoid neurological damage, early diagnosis is essential.

Types

Discitis
Osteomyelitis of the vertebrae
Abscess in the epidural
Tuberculosis in the spine

Risk Elements

Diabetes
Immunosuppressive
Use of intravenous drugs
Prior spinal surgery

Symptoms

Back pain that never goes away
Malaise and fever
Loss of weight
Deficits in the nervous system

Diagnosis

Blood tests (CRP, ESR)
MRI using contrast
Biopsy of tissue

Treatment

Anti-tubercular medication or long-term antibiotics
Immobilization
If necessary, surgical drainage or stabilization

1. Tuberculosis
2. Pyogenic

C4 vertebral body TB with kyphosis

Multilevel TB destruction with kyphosis

High Thoracic Tuberculosis with Paraplegia

Decompression, Trans-pedicular bone graft and fusion

Lumbar Spine Tuberculosis

Multi focal Tuberculosis

X ray – Severe osteoporosis with acute kyphosis with 64 degrees
CT- vertebral body destruction and retropulsion
MRI reported Infective Spondylitis T12 and L1 vertebral body with cord compression

85 year old with TB and Kyphosis

Underwent single stage PMMA augmented screw fixation T9-L4 and anterior reconstruction with cage, bone grafting and local kyphosis correction.
Biopsy reported as tuberculosis spine for which ATT was given
Once weekly teriparatide dose of 60µg for 6 weeks.

Cancellous and cortical bone clearly increased, with enhanced stability in CT, after 6 weeks of treatment
Elderly patients with thoracolumbar tuberculosis and severe osteoporosis, PMMA augmented screw fixation was safe and effective..