Spinal infections are rare but can be deadly, so you need to get a proper diagnosis as soon as possible if you have spinal pain.
Read on to learn more about what spinal infections are, the types of spinal infections, how to recognize them, and how to treat them. Each kind of spine infection has its own causes, symptoms, and treatment.
What Is a Spinal Infection?
Spinal infections are bacterial or fungal infections that happen in or around your spine or backbone. You can have different symptoms depending on what kind of spinal infection you have.
For instance, if your infection involves the space between the parts of your backbone, known as the vertebrae, you may have trouble peeing, weight loss, fever, and severe back pain.
If you think you have a spinal infection, talk to your doctor immediately to get a proper diagnosis. Otherwise, the infection may cause irreversible damage to your backbone and the areas around it.
Osteomyelitis
Osteomyelitis is a bone infection. It can affect any of your bones, but adults usually get osteomyelitis in their hips or vertebrae (the bones making up your spine). This infection is quite rare, but you are more at risk of getting it if you recently had an injury, underwent surgery, or have a weakened immune system.
What causes this bone infection?
This condition can be caused by bacteria or fungi spreading into your bone marrow (the spongy material at the center of most bones). There are a few ways infection can get into your spine:
- Surgery, such as from spinal metalwork
- Infection spreading from the surrounding tissue
- Infections in the blood
What are the symptoms of osteomyelitis?
The main symptom people with osteomyelitis have is pain in the spine, specifically, backbone pain that gets worse when you move around. This is one of the main signs of osteomyelitis.
Often, pain is the only symptom, making this condition hard to diagnose. In some cases, you may also have weakness, weight loss, numbness, and tingling.
How to treat this spinal infection
To find out if you have this condition, your doctor may order:
- Blood tests to test your white blood cell levels
- X-rays
- CT scans to see your spine in more detail compared to X-rays
- MRI scans to see soft tissue, such as the nerves in your spine
Your doctor will then look at the results to figure out how far the infection has spread and if any abscesses (pocket of pus) have formed. Doctors typically prescribe antibiotics or antifungals to treat osteomyelitis, depending on the cause of the infection. If you have an abscess, your doctor may use a needle to drain it. If the infection is very bad or if you have a high risk of complications, you may need surgery.
Discitis
Discitis is when the discs in between your vertebrae, known as intervertebral discs, are inflamed. Some believe that discitis and osteomyelitis are stages of the same disease.
What causes disc inflammation?
This is an infection that can happen after surgery or on its own. It can be caused by the bacterium Staphylococcus aureus, which is the most common cause, as well as other bacteria such as streptococcus.
You can develop discitis due to a urinary tract infection or pneumonia spreading throughout your body through your bloodstream.
Discitis can also be caused by trauma and autoimmune disorders.
What are the symptoms of discitis?
If you have discitis, you may have pain in your lower back and neck that doesn't go away and worsens when you move, stiffness and reduced flexibility in the spine, fever, chills, loss of appetite, and fatigue.
How is discitis treated?
There are many ways to treat discitis. Treatments can range from antibiotics to spinal bracing. Most of the time, discitis is treated with antibiotics and, sometimes, with surgery.
If surgery is needed, debridement (the removal of infected tissue) will probably be done.
Meningitis
Meningitis is an inflammation (swelling) of the protective membranes surrounding the brain and spinal cord, called the meninges. It can cause many problems if not treated properly or on time.
How do you get meningitis?
Meningitis is most commonly caused by infections — typically viral. But it can also result from bacterial, fungal, or parasitic infections. In some cases, meningitis may be triggered by chemical reactions, certain medications, allergies, specific types of cancer, or conditions such as sarcoidosis.
What are the symptoms of meningitis?
If you have meningitis, early symptoms may be like those of the flu, such as fever and muscle aches (myalgias). You are also likely to have specific symptoms of meningitis, such as:
- Neck stiffness
- Headache
- Nausea or vomiting
If the brain tissue itself is affected, you may have:
- Seizures
- Confusion
- Trouble speaking and moving
How is meningitis treated?
Your doctor may do the following tests to see if you have meningitis and what the cause may be:
- Blood culture to check for the presence of bacteria in your blood
- Imaging tests such as CT or MRI scans of the head can detect brain swelling; chest X-rays or sinus CT scans may show infections linked to meningitis.
- Cerebrospinal fluid (CSF) analysis to look at protein and glucose levels and cell count
If you have bacterial meningitis, your doctor will immediately give you antibiotics and corticosteroids. On the other hand, viral meningitis can go away by itself over a couple of weeks or months. So, doctors will give you supportive treatment and any appropriate antiviral medication.
Is meningitis contagious?
If meningitis is caused by a bacterial or viral infection, then it can spread from person to person. If someone in your household has meningitis:
- Wash your hands often, especially before eating
- Avoid close contact and don’t share cups, utensils, or toothbrushes
- Ask your doctor if you should take antibiotics (for bacterial meningitis)
Paraspinal Abscess
A paraspinal abscess is a rare but serious condition involving the buildup of bacteria and pus, along with inflammation (swelling and irritation) within or around the spinal cord.
What causes paraspinal abscesses?
A paraspinal abscess happens when an infection forms next to your spine. Often, the infection starts in the bone around your spine (osteomyelitis). From there, it may create a pocket of pus, or abscess. As it grows, it can press on your spinal cord and spread into it.
Bacteria, most often staphylococcus, usually causes paraspinal abscesses. Less commonly, tuberculosis or a fungus may be the cause.
Here are things that can raise your risk for a paraspinal abscess:
- A back injury, even a small one
- A lumbar puncture (a test to look at the fluid that surrounds the brain and spinal cord) or back surgery
- An infection somewhere else in your body that spreads through your blood
- Injected street drugs
- Boils or skin infections on your back or scalp (this is rare)
Symptoms of paraspinal infections to watch out for
You might notice one or more of these symptoms if you have a paraspinal abscess:
- Fever and chills
- Trouble controlling your bladder or bowels
- Weakness or numbness below the abscess
- Lower back pain that gets worse over time and spreads to other areas
How are paraspinal abscesses treated?
Paraspinal abscesses are treated with a mix of surgery and antibiotics. Antibiotics help clear the infection and are usually given intravenously (via a needle in your vein). If the abscess puts pressure on your spinal cord, doctors may need to do surgery at once. This involves removing part of the spine bone near the abscess and draining the pus.
How Are Spinal Infections Diagnosed?
Doctors diagnose spinal infections by reviewing your medical history, doing a physical exam, and ordering specific tests, says Georgiy Brusovanik, MD, an orthopedic spine surgeon at Miami Back and Neck Specialists in South Miami, Florida.
Besides a painful back, there are certain symptoms doctors look for. “Specifically nighttime pain, sweats, and a sensation of being sick,” Brusovanik says.
If your doctor thinks you have a spinal infection, they will usually order an MRI scan to look for signs of infection in your spine. To confirm the diagnosis, they may also do a specialized test called an indium-labeled bone scan. This involves drawing a small amount of your blood, attaching a tracer substance (radioactive indium) to your white blood cells, and then injecting those cells back into your bloodstream. A special camera then tracks where those labeled cells collect in your body, which helps doctors spot areas of infection.
Takeaways
There are many types of spinal infections. Osteomyelitis affects the bones in your spine, while discitis involves inflammation in the discs between vertebrae. Meningitis causes swelling of the protective layer around the spinal cord, and a paraspinal abscess is a pocket of pus within or around the spinal cord. To diagnose a spinal infection, doctors usually check for signs and symptoms and order imaging tests such as MRI scans or specialized bone scans. Early diagnosis and treatment are important to help keep serious complications from happening.
Spinal Infection FAQs
How long does it take to recover from a spinal infection?
Recovery from a spinal infection can take anywhere from days to many months, depending on the type of the infection and how bad the it is, Brusovanik says. For example, meningitis may be cured after a few days of IV fluids, whereas tuberculosis of the spine may need surgery that may lead to weeks and even months of recovery time, he says.
How do you get a spinal infection?
Spinal infections usually happen in one of two ways, Brusovanik says. Germs can travel through your bloodstream from another part of your body and settle in your spine, or they can enter the spine during or after surgery.
Is an infection in the spinal column serious?
Yes, spinal infections are very serious and can lead to major complications if not treated quickly. “They may cause worsening pain, deformity, and possibly paralysis,” Brusovanik says. If a spinal abscess is present, treatment should begin within 24 hours to help keep permanent damage from happening, he adds.
Can COVID cause a spinal infection?
COVID does not directly cause spinal infections, Brusovanik says. But it may raise your risk of getting a spinal infection by lowering your immunity.
