Spinal infections can be classified by the anatomical location involved: the vertebral column, intervertebral disc space, the spinal canal, and adjacent soft tissues. Infection may be caused by bacteria or fungal organisms, and can occur after surgery. Most postoperative infections occur between three days and three months post surgery.

 Vertebral osteomyelitis is the most common form of vertebral infection. It can develop from direct open spinal trauma, infections in surrounding areas, and from bacteria that spreads to a vertebra.

Intervertebral disc space infections involve the space between adjacent vertebrae. Disc space infections can be divided into three subcategories: adult hematogenous (spontaneous), childhood (discitis), and postoperative.

Spinal canal infections include spinal epidural abscess, which is an infection that develops in the space around the dura (the tissue that surrounds the spinal cord and nerve root). Subdural abscess is far rarer and affects the potential space between the dura and arachnoid (the thin membrane of the spinal cord, between the dura mater and pia mater). Infections within the spinal cord parenchyma (primary tissue) are called intramedullary abscesses.

Adjacent soft-tissue infections include cervical and thoracic paraspinal lesions and lumbar psoas muscle abscesses. Soft-tissue infections generally affect younger patients and are not seen often in older people.

Risk factors for developing spinal infection include conditions that compromise the immune system, such as:

  1. Advanced age
  2. Intravenous drug use
  3. Human immunodeficiency virus (HIV) infection
  4. Long-term systemic usage of steroids
  5. Diabetes mellitus
  6. Organ transplantation
  7. Malnutrition
  8. Cancer

 Surgical risk factors include an operation of long duration, high blood loss, use of instrumentation, and multiple or revision surgeries at the same site. Infections occur in 1 to 4 percent of surgical cases, despite numerous preventative measures that are followed.

Spinal Infections Overview

  • Causes

  • Symptoms

  • Vertebral osteomyelitis

  • Intervertebral disc space infections

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