Spinal infection - Diagnosis
Primary spinal infection presents sometimes with or after infections of other body regions, for example gallbladder, joints, lung infection or even infection of the heart membranes (endocarditis). In addition to the previously described risk factors, another infection in the body together with back pain (not related to effort and worse at night) should raise the suspicion of spinal infection. Fever may also be present.
Secondary infection after any spinal intervention can also occur, yet rare. In this case the history provided of increased back pain after an intervention and other symptoms of infection are the clue for diagnosis.
Some cases of spinal infections can lead to paralysis of all limbs (when the cervical spine is affected) or of both lower limbs (when thoracolumbar spine is affected). This paralysis can occur through pus formation in the spinal canal (abscess) or through abnormal mobility of the infected segment (instability), both leading to compression of the nerve structures in the canal (spinal cord or nerve roots).
The diagnosis will be mainly through a magnetic scan (called an MRI) of the spine. The MRI will show exactly how much the spinal canal is narrowed and how much it is affecting the spinal cord. A blood test is also very important and may show non-specific abnormalities which also reflect the infection grade.