ICAC | Traumatólogos especialistas en infección vertebral

Which is a spinal infection?

Infection of the spinal column is caused by the invasion of a microorganism.

This pathology of the spine has different names, depending on the exact area it affects.

Types of spinal infection

exist different varieties of spinal infection that serve to define this back pathology:

  • infectious discitis: inflammation of the intervertebral disc, caused by the E. coli bacteria in most cases.
  • Spondylodiscitis: in this case, the infection affects the intervertebral disc and the vertebra.
  • Ankylosing spondylitis (vertebral osteomyelitis): It is a type of arthritis that originates in the bones and joints of the spine. It causes an increase in volume of these joints, as well as the pelvis and vertebrae.
  • Meningitis: The infection reaches the membranes that are part of the nervous system, and can generate an epidural abscess (accumulation of pus and germs that causes swelling), compressing the spinal cord. Since it can spread to the spinal cord, this pathology can be disabling or fatal in the most extreme cases.

All the information about spinal infection

The anatomy of spinal infection varies between adults and children. Adults do not have a vascularized intervertebral disc (provided with blood vessels), which reduces the probability of germs entering through the bloodstream, thus reducing the incidence of infections.

In children, the intervertebral discs are close to the vascular channels, which facilitates the arrival and implantation of germs. This makes the infection more common at this stage of life, and it can originate from other infected areas of the body or from contamination due to external agents.

Infections that affect the spine they usually are caused by microorganisms, mainly bacteria such as staphylococcus and occasionally fungi. These infections generally originate in other areas of the body such as the genitourinary tract, skin or respiratory tract. Through hematogenous (blood) dissemination, these germs can implant in the vertebrae or intervertebral discs.

One of the main triggers of these infections in the vertebrae or intervertebral discs is post-surgery, after performing open spinal surgery. In these cases, immunosuppressed patients (immune system that functions below the normal level), diabetics, those with chronic pathologies, obesity, smokers, anemic or malnourished, and those undergoing prolonged surgeries, are at greater risk.

These infections can manifest in superficial planes, causing the surgical wound to open, or they can infect deeper planes, affecting muscles, fascia, vertebral ligaments and intervertebral discs.

Other causes may include wounds close to the spinal column or the penetration of contaminated foreign bodies into these structures.

The symptoms of spinal infection usually manifest with localized pain in the back or the affected region of the spine, accompanied by fever in acute cases.

If the germs have arrived through another infected organ, such as the skin, the genitourinary system or the respiratory tract, signs of involvement in the vertebrae are added to the general symptoms. Any infectious condition leads to apathy and general malaise, along with fever. However, the primary symptom of spinal infection is pain focused on the affected area of the back.

If the infection advances in the vertebral body or intervertebral disc, a greater weakening of these can occur, leading to necrosis and vertebral crushing.

The progression of the infection towards the layers that cover the spinal cord or peripheral nerves can cause neurological alterations.

In the case of an infected surgical wound, it is common for its edges to open and serous and purulent staining to occur through that wound (serum and pus). This infection can penetrate deeper and increasingly affect more perivertebral structures with increased pain.

Diagnosing these pathologies can be challenging when the infection spreads through the blood (hematogenous dissemination), which can lead to delays in diagnosis and require differential analysis with inflammatory, degenerative or tumor diseases.

To carry out the diagnosis of spinal infection processes and differentiation with other pathologies is usually required:

  • Blood test
  • X-ray studies
  • CT and MRI
  • Bone scintigraphy
  • Taking a sample for culture by puncture or directly from the affected bed, which may include soft tissues and infected bone.

The treatment approach for spinal infection depends on the severity and extent of the infection, as well as the type of causative microorganism. Generally, the use of specific intravenous antibiotics.

If samples are taken from the infected area, it is possible to analyze and culture them in the laboratory and obtain the germ causing the infection. In this way, the patient will take the most effective antibiotic for their treatment (antibiogram).

In some cases, it is necessary to resort to spinal surgery for cleaning and debridement (removal of dead, damaged or infected tissue to improve the health of the remaining tissue) of all infected structures.

If the infection progresses and vertebral subsidence and fractures occur, a broader excision of the infected area may be necessary, followed by structural fixation to prevent compression of the vertebrae, nerve roots, or spinal cord.

Our Specialist traumatologists are pioneers in spine surgeries in Madrid.

Preventing spinal infections is essential to take care of the health of the spine. Taking preventive measures can make a big difference in protecting it. Some key guidelines to achieve this include:

  • Hygiene and postoperative care: Rigorously disinfecting wounds after spinal surgery and following medical instructions is essential to prevent infections.
  • Control of underlying diseases: Controlling and treating medical conditions such as autoimmune diseases or diabetes is of utmost importance to reduce the risk of spinal infections.
  • Promote healthy lifestyle habits: Maintaining a strong immune system through a balanced diet, regular exercise and adequate rest is key to strengthening the body's defenses.
  • Education and awareness: Being informed about the signs of infection and understanding the importance of seeking immediate medical attention for any concerning symptoms is essential to prevent complications.

Adopting these preventive measures can significantly reduce the risk of spinal infections, thus preserving the health of the spine. It is essential to remember the importance of seeking medical attention when symptoms appear. to prevent the condition from worsening.

There are multiple factors that can increase susceptibility to spinal infections. These factors include:

  • Recent spinal surgery: Surgical procedures on the spine can open an entry route for bacteria, increasing the risk of infection.
  • weak immune system: People with compromised immune systems due to diseases such as HIV/AIDS, cancer or diabetes are at greater risk of developing infections.
  • Trauma or injuries: A spinal injury can facilitate the entry of bacteria or other pathologies into the affected tissue.
  • Intravenous drug abuse: Intravenous drug use may increase the risk of spinal infections due to the direct introduction of bacteria into the bloodstream.
  • Advanced age: Older adults are often at higher risk due to natural tissue degeneration and possible decreased immunity.

Addressing these risk factors and taking preventive measures can significantly reduce the likelihood of contracting spinal infections.

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Important announcement

The ICAC, now at Teknon in Barcelona

This month of June, We have begun our collaboration with the prestigious Barcelona clinic TMEH to offer spine services at the famous Teknon Medical Center, one of the leading healthcare hospitals in Europe. Thanks to this alliance, we provide a comprehensive and specialized approach with the best solutions for those suffering from back problems.

The ICAC human team, known for being at the vanguard of innovation in traumatology, now brings his talent and advanced ultra-minimally invasive surgery techniques to Barcelona.

This collaboration with TMEH at Teknon Medical Center not only allows us to treat more patients more effectively, but also reinforces our commitment to innovation and excellence in healthcare.

We are excited to be able to offer these services in one of the most important cities in Europe and continue leading the field of traumatology and, in this specific case, in the treatment of the spine.