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Spinal Infections
Bacteria or fungal organisms may cause infection in the vertebral column, the intervertebral discs, the dural sac, or even in the space around the spinal cord. Infections in these areas may occur for a variety of reasons.
The most likely occurrence of spinal infection may develop between three days to three months post surgery. Patients with certain inherent risk factors such as immune suppression, poor nutrition, HIV infection, diabetes, obesity, and cancer are the most at risk.
Other factors include lengthy surgical procedures, reoperations, and the instrumentation itself. Despite the numerous preventative measures that are followed, infections do occur in approximately 4-10 percent of all surgical cases. Of course, the possibility of infection increases proportionately with the number of operations performed in any given area and in patients with associated conditions such as obesity, diabetes, tobacco usage and immunosuppression.
Symptoms
The symptoms accompanying spinal infections range from extremely subtle to very severe in nature. They include chills, fever, neck stiffness, headache, wound redness and drainage, tenderness, and pain.
Nonoperative Treatment
Antibiotic or antifungal medications are the first choice in nonoperative management of some spinal infections. The location and severity of the infection along with the type of organisms causing the infection will determine the type and duration of the treatment.
The antibiotics or antifungal medications may be delivered orally or intravenously with the aid of an IV line. The treatment may be as short as seven to ten days or longer (six to twelve weeks) depending on the nature and severity of the infection.
In some cases, the patient may require the placement of a special intravenous (central) line for the delivery of medications. Home administration, with the assistance of a visiting nurse, is sometimes advised. In addition, the doctor may prescribe a brace to support the spine throughout the healing process. This support will also help provide relief from pain.
Surgical Treatment
In severe cases, surgery may be recommended to wash and clean away the bacteria and infected tissue. If evidence of spine instability is present, surgery may also be required to stabilize the spine. In addition, if neurologic deterioration occur as the result of a spinal infection, surgery may be advised to relieve the pressure on the spinal cord.
To completely treat some spinal infections, a combination of long-term antibiotics along with surgery may be required. The doctor will monitor the patient’s white blood cell count, the erythrocyte rate, as well as, C-reactive protein level to determine the patient’s response to therapy.
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