One of the many remarkable things about the human spine is its resilience. However, it’s an entirely different ballgame if an infection like vertebral osteomyelitis gets into your backbone. Vertebral osteomyelitis a rare type of infection that often develops when bacteria gets into the spine through veins in the lower back (Batson’s plexus) that connect to other veins deep in the pelvic area. Sometimes, the body can naturally fight this type of infection with little or no intervention. Other times, treatment is necessary once a positive diagnosis is made by a Beverly Hills spine surgeon.
A staph infection (Staphylococcus aureus) is the most common source of spine-related infections, although this isn’t always the case. For this reason, the specific type of bacteria involved needs to be identified prior to treatment. It’s also possible for an infection to develop after having a urologic procedure and make its way from pelvic veins to the lower back.
Because spine infections are rare, vertebral osteomyelitis can be difficult to diagnose, especially when back pain is the only noticeable sign something may be wrong. It’s clearer that an infection may be involved if symptoms include sudden or unexplained weight loss, fever, pain that’s worse at night, or swelling around the affected vertebral body. Following an initial physical exam and review of medical history, testing often involves:
- X-rays to identify possible bone damage
- An MRI to look for increased blood flow
- A blood sample to check for certain biomarkers that suggest an infection
- A white blood cell count to see if levels are elevated (suggests the body is fighting an infection)
- Culture testing from a sample collected with a needle biopsy*
*A needle biopsy is usually only done in rare cases when an infection is difficult to detect with other methods.
Treatment for vertebral osteomyelitis usually includes intravenous antibiotic therapy for approximately 4-6 weeks followed by the use of oral antibiotics for a few more weeks. The duration of antibiotic treatment can vary based on the severity of the infection and type of infection involved. For instance, an infection caused by tuberculosis may require drug treatment for about a year.
Additionally, patients are typically advised to rest. A lower back brace may also be worn for 6-12 weeks to stabilize the lumbar spine during the healing and recovery process. A rigid brace worn when the patient is active usually works best.
Spinal nerves aren’t usually affected by vertebral osteomyelitis. However, if an epidural abscess develops because of the infection, nerves in the lower back area may be irritated. If this happens, surgery may be necessary. If the spine becomes unstable during a decompression procedure, a fusion may also be performed to restore stability. Surgery may also be needed to:
- Remove infected material (surgical debridement)
- Correct bone deformities caused by the infection
- Prevent further deterioration or collapse of the affected area of the spine
Vertebral osteomyelitis can affect anyone, although certain individuals are at a greater risk of developing this type of spinal infection, including older adults, IV drug users, cancer patients, organ transplant recipients, anyone with a weakened immune system, and insulin-dependent diabetics. While spine infections aren’t always preventable, reporting sudden or persistent back paint to your doctor, even if there are no other symptoms, can make it more likely you’ll be diagnosed and treated before the infection spreads or affects spinal stability.
Get in touch with The Spine Institute if you think you might need fusion surgery or an alternative to spinal fusion. Beverly Hills patients can put their trust in Dr. Hyun Bae and his team of expert surgeons. Call 310-828-7757 today to schedule an in-person evaluation.