Discitis (inflammation return)
Lower Back | Orthopaedics | Discitis (inflammation return) (Disease)
Discitis or diskitis is an infection in the intervertebral disc space that affects different age groups, but usually spontaneously affects children under 8 years of age. Nonetheless, discitis occurs post surgically in approximately 1-2 percent of patients status post spine surgery. A person with discitis (diskitis) has swelling or irritation of the space between the bones of the spine caused by a viral or bacterial infection.
Symptoms include severe back pain, leading to lack of mobility. Some very young children may refuse to walk and arching of the back is possible. In post-operative situations, the symptoms occur within a week and result in severe low back pain or neck pain (depending on the surgical location). If untreated, the discitis may resolve on its own, cause a chronic low grade infection, or progress to osteomyelitis and possibly even an epidural abscess. In case of concomitant inflammation of one or more vertebrae (in such cases usually a the areas adjacent to the intervertebral disc spaces) the condition is called spondylodiscitis.
Causes and Risk factors
Discitis is considered when there is osteomyelitis of a vertebral body (in the spine). In most cases, discitis spreads through the bloodstream to the spine from another location in the body. Possible sites include pneumonia, urinary tract infection, and a soft tissue infection. Staphylococcus aureus is the organism most commonly found.
Diagnosis and Treatment
The treatment of discitis includes nonsteroidal anti-inflammatory medications and narcotic pain medications to reduce pain. Antibiotic selection is based on the isolated organism. Intravenous antibiotics are usually administered for 6 to 8 weeks. Immobilization is necessary, particularly in the early stage of the disease. ...