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Spinal infection - Diagnosis

Because spinal infection is a very rare condition with an incidence of 4-10 cases per million yearly, the disease is often diagnosed late. The symptoms are also usually non-specific but taking detailed history from the patient is necessary for the doctor to suspect this and go on with further diagnostic methods.

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.

EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.
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