Vertebral Osteomyelitis is an infection of the bones of the spine, causing weakness in its structure or pressure on the spinal cord or nerve roots. It may be caused by urinary or respiratory tract infection, soft tissue infection, or dental infection spreading to bone, or it may occur on the site of a previous spinal surgery. The lumbar spine is the most common site, followed by thoracic, cervical, and sacrum.
Symptoms may include fever, back pain, weight loss, radicular pain (pain down an extremity), weakness, sensory loss (numbness), spasticity (stiffness), and bowel or bladder.
The primary method of diagnosis is a combination of plain x-rays and MRI scans. Other diagnostic studies of use include a myelogram, bone scan, or a gallium scan.
The treatment depends upon the symptoms and the degree of bony damage. With little or no symptoms and no bony instability, the primary treatment method is medical with intravenous antibiotics. If compression on neural structures is seen on the diagnostic studies, operative removal of the compressive infection may be required; if there is evidence of spinal instability, a spinal fusion procedure may be required.
