Spine problems can cause severe pain and disability, and one of the rare but serious conditions affecting the spine is spondylodiscitis. This condition involves infection and inflammation of the intervertebral disc and adjacent vertebrae, which can lead to severe pain, restricted mobility, and long-term complications if not diagnosed and treated early.
In this article, we will understand what spondylodiscitis is, its causes, symptoms, diagnosis, and available treatment options.
What is Spondylodiscitis?
Spondylodiscitis is an infection of the intervertebral disc space and the adjacent vertebral bones. It is usually caused by bacteria, but in some cases, it can also be due to fungal or tuberculosis (TB) infections.
- The infection usually starts in the disc and spreads to the vertebral bodies.
- It can lead to progressive destruction of bone and disc, causing spinal deformity and, in severe cases, neurological complications such as weakness or paralysis.
Spondylodiscitis is more common in elderly individuals, patients with weakened immunity, or those with chronic illnesses. However, it can occur at any age.
Causes of Spondylodiscitis
Several factors can lead to the development of spondylodiscitis. The main causes include:
- Infections
- Bacterial infections (commonly Staphylococcus aureus and Escherichia coli) spread to the spine through the bloodstream.
- Tuberculosis (TB) of the spine, also called Pott’s spine, is a common cause in developing countries like India.
- Fungal infections, though rare, may occur in immunocompromised patients.
- Risk Factors
- Older age
- Diabetes mellitus
- Chronic kidney disease or patients on dialysis
- Cancer or immunosuppressive therapy
- Intravenous drug abuse
- History of recent spinal surgery or invasive spinal procedures
Symptoms of Spondylodiscitis
The symptoms can vary depending on the severity of infection and duration. The most common signs include:
- Severe back pain – persistent, progressive, and not relieved by rest.
- Restricted movement – stiffness in the spine due to pain.
- Fever and malaise – indicating infection.
- Neurological symptoms – such as tingling, numbness, or weakness in the arms/legs if the infection compresses the spinal cord or nerves.
- Difficulty in walking or standing in advanced cases.
- Weight loss and night sweats in cases of tuberculosis-related spondylodiscitis.
Patients often seek medical help only when pain becomes unbearable or when they develop neurological symptoms.
Diagnosis of Spondylodiscitis
Early diagnosis is very important to prevent complications. Doctors usually perform the following tests:
- Clinical Examination
- Detailed medical history and physical examination to assess back pain, stiffness, and neurological status.
- Blood Tests
- Complete blood count (CBC) – to check for infection.
- ESR (Erythrocyte Sedimentation Rate) and CRP (C-reactive protein) – usually elevated in infection.
- Blood cultures may identify the causative bacteria.
- Imaging Studies
- X-rays may show late changes like disc space narrowing or bone destruction.
- MRI scan is the gold standard, showing early signs of infection and soft tissue involvement.
- CT scan helps evaluate bone damage in detail.
- Biopsy
- A tissue biopsy from the infected site may be done to confirm the diagnosis and identify the exact organism.
Treatment of Spondylodiscitis
The treatment depends on the severity of infection, the causative organism, and the patient’s overall health.
1. Medical Management
- Antibiotics are the first line of treatment for bacterial spondylodiscitis. The choice of antibiotics depends on culture results.
- Anti-tubercular therapy (ATT) is given in cases of spinal TB (Pott’s spine).
- Antifungal medications may be needed for fungal infections.
- Pain management with analgesics and anti-inflammatory drugs.
- Immobilization using a spinal brace to reduce pain and provide stability during healing.
2. Surgical Management
Surgery is required in certain situations, such as:
- Severe pain not improving with medicines.
- Spinal instability due to extensive bone destruction.
- Development of neurological deficits like weakness or paralysis.
- Large abscess formation.
Surgical options may include:
- Debridement – removal of infected tissue.
- Spinal fixation – using rods and screws to stabilize the spine.
- Vertebroplasty or kyphoplasty – in cases of osteoporotic fractures.
- Decompression – relieving pressure on nerves or spinal cord.
Prognosis and Recovery
With timely treatment, most patients recover well. However, delayed diagnosis may lead to permanent spinal deformity or neurological damage.
- Medical treatment usually lasts for 6–12 weeks in bacterial infections and longer (9–12 months) in TB cases.
- Rehabilitation with physiotherapy plays a key role in regaining mobility and strength after treatment.
- Patients are advised regular follow-ups and imaging studies to ensure complete healing.
Prevention of Spondylodiscitis
While not all cases can be prevented, certain measures help reduce the risk:
- Maintain good hygiene during medical procedures.
- Treat infections in the body promptly to avoid spread through the bloodstream.
- Strengthen immunity with a balanced diet, regular exercise, and management of chronic illnesses like diabetes.
- Avoid self-medication and seek medical attention for persistent back pain.
Conclusion
Spondylodiscitis is a serious but treatable condition. It requires early recognition, proper diagnosis, and timely treatment to avoid long-term disability. If you or a loved one experiences severe, persistent back pain associated with fever, weight loss, or neurological symptoms, it is important to consult a spine specialist immediately.
With advances in imaging, medications, and surgical techniques, patients with spondylodiscitis can achieve excellent recovery and return to a normal quality of life.
For Consultation Contact us on 9158680739 / 9158681123
Website – www.chetnahospital.co.in
Address – Chetna Hospital, Sambhajinagar, MIDC, G Block, Near Rotary Club, Chinchwad 411019
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