What is vertebral osteomyelitis?

Vertebral osteomyelitis is a rare spinal infection caused by bacteria or fungi. It is a painful bone infection that can develop due to an injury to the spine or after surgery. The disease can also spread from another place in the body to the spine in the bloodstream. Other names for this condition include spinal osteomyelitis and spondylodiskitis.

Who is affected by vertebral osteomyelitis?

According to research, more men than women develop vertebral osteomyelitis. The chances of it happening increase as you get older.

You may be more likely to get vertebral osteomyelitis if you:

• Are unwell and live in a nursing home.
• Are on dialysis.
• Have sickle cell disease.
• Inject drugs using needles that aren’t sterile.

How common is vertebral osteomyelitis?

Studies estimate that vertebral osteomyelitis happens to about 4.8 per 100,000 people, increasing over time. One estimate is that 26,170 to 65,400 people in the U.S. develop the condition yearly, but it’s hard to be exact because vertebral osteomyelitis is difficult to diagnose.

What are the signs and symptoms of vertebral osteomyelitis?

Signs and symptoms of vertebral osteomyelitis may include:

Back pain that gets worse when you move and doesn’t get better with home treatments like taking pain relievers, applying heat, or resting.

Weakness.

Numbness and tingling.

Weight loss.

You might not have a fever if you have vertebral osteomyelitis.

What causes vertebral osteomyelitis?

Germs cause vertebral osteomyelitis, and the most common cause is the bacterium Staphylococcus aureus, also known as staph. Staph itself is familiar. About 30% of the population have staph in their noses without consequences. However, staph infections can be severe when they do happen.

Other germs, such as fungi or Mycobacterium tuberculosis (the germ responsible for tuberculosis), can cause vertebral osteomyelitis.

If you break a bone or something pierces your bone, you can develop a bone infection. Blood can spread infections from nearby soft tissue areas if infected. Bedsores can lead to infections elsewhere in your body, including bones. So can urinary tract infections.

Is vertebral osteomyelitis contagious?

Bone infections like vertebral osteomyelitis aren't contagious, but the germs that cause them are. You can pass the actual germs to another person.

How is vertebral osteomyelitis diagnosed?

The symptoms of vertebral osteomyelitis can resemble those of other diseases. In addition to taking a medical history and examining you, your healthcare provider will order diagnostic tests such as:

Blood tests, such as ones to test for inflammation, like the erythrocyte sedimentation rate, or a test for how much C-reactive protein is in your blood or how many white blood cells there are. Blood, tissue, pus, and fluid from your joints and bones may be tested to determine the type of germ causing the infection.

Imaging tests such as MRI scans, computed tomography (CT) scans, and X-rays can identify problem areas in your bones. Your doctor may also ask for a bone scan.

Biopsy. In this procedure, your surgeon removes a sample of tissue or bone to diagnose and determine which antibiotic would be most helpful. In this case, your doctor may use CT to direct the biopsy.

What is the best treatment for vertebral osteomyelitis?

Your doctor will give you antibiotics to treat vertebral osteomyelitis. You may receive oral, non-oral, or both medications. Generally, you will be treated for at least six weeks.

Your healthcare provider might also suggest back braces to help keep your spine stable and rehabilitation to improve muscle strength.

You might also need surgery to drain pus from the infected area or to stabilize your vertebrae, so they don’t collapse.

How can I prevent vertebral osteomyelitis?

Men are more likely to develop vertebral osteomyelitis.

There are some risk factors you can influence, though, like:

• Avoid injecting any drug that isn't prescribed for you, and avoid using dirty needles.
• Manage diabetes by following instructions from your healthcare provider.
• Avoid skin infections by taking care not to get scratched or cut. If you do have some wound, make sure you clean it well.
• Follow a healthy lifestyle by eating well, exercising, and getting enough sleep.

What is the outlook (prognosis) for someone with vertebral osteomyelitis?

With treatment, you may recover from vertebral osteomyelitis in a month to six weeks. However, it takes up to six months to fully recover.

Without treatment, you may develop severe spine damage or septicemia (blood poisoning from bacteria). Death occurs in about 20% of

Living With

When should I contact my healthcare provider about vertebral osteomyelitis?

It's best to seek treatment early. Contact your healthcare provider if:

You ve just had surgery or have an infection, even one such as a urinary tract infection, and you feel pain in your neck or back that won't stop no matter what you do.

You have a fever that isn't controlled by medication.

You've had a dental procedure or have injected drugs, and you have neck or back pain that isn’t getting better.

You're recovering from vertebral osteomyelitis, and symptoms are getting worse, or you develop a new symptom.

To seek an expert consultation for any orthopedic condition.

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