Osteomyelitis of the spine
Spinal osteomyelitis is a serious illness caused by an infection of the bone tissue. Staphylococcus aureus is the source of infection in about 85% of cases. Features of pathology - the complexity of diagnosis at the initial stage, the danger to the patient's life, the need for long and urgent treatment.
Content:
- Types of spinal osteomyelitis
- Spinal osteomyelitis symptoms
- Causes of osteomyelitis of the spine
- Diagnostics
- Spinal osteomyelitis treatment
Types of spinal osteomyelitis
Osteomyelitis of the spine is divided into two types: acute and chronic.
- The acute form is diagnosed by a doctor at the first occurrence, is characterized by the rapid spread of the inflammatory process. If untreated, an abscess and other negative consequences may develop.
- The chronic form is characterized by a long course, the stages of remission are replaced by periodic exacerbations. Pathology adversely affects the bone marrow, can lead to blood diseases.
Spinal osteomyelitis symptoms
The main symptom is back pain, which cannot be removed by heat. It can be reduced under the influence of painkillers, with a long stay of the patient in bed. Touching the infected area is painful.
Other manifestations of spinal osteomyelitis also occur:
- chills, high fever;
- heart palpitations;
- convulsions;
- decrease in pressure;
- excessive sweating;
- weight loss;
- increasing pain at night;
- the severity of the venous pattern in the affected area
Localized pain occurs approximately two days after infection. The patient loses the ability to active movements.
Causes of osteomyelitis of the spine
The resistance of bone tissue to infectious agents is quite high. The development of osteomyelitis of the spine occurs under favorable conditions that increase the susceptibility of bones to infection.
Risk factors are as follows:
- surgical intervention;
- injury;
- circulatory disorders (can be caused by diabetes mellitus, sickle cell anemia);
- intravenous drug use (untreated needles);
- medical catheters (become conductors of infection);
- elderly age;
- weakening of the immune system (cancer, AIDS, malnutrition, diabetes, corticosteroid treatment).
Diagnostics
Diagnosis of spinal osteomyelitis is carried out using the following instruments:
- Radiography. With its help, the doctor identifies the pathological process occurring in the bone structure. Its application will give results only if the duration of the spread of the pathological process is several weeks or more. In the early stages, the technique is ineffective.
- CT. Conducting computed tomography allows you to identify changes that have occurred in the bone tissue, to detect foci of pus. The examination allows you to identify the degree of damage, since multiple and single foci are possible.
- MRI. Magnetic resonance imaging contributes to the accurate detection of bone pathology. The study allows not to confuse the inflammatory processes occurring in the bone canal with the defeat of soft tissue infection.
- Ultrasound. An ultrasound examination provides information on areas of abnormal fluid concentration. With the help of ultrasound, information about the edema of soft tissues can be obtained, it also helps to detect defects formed on the surface of the bone, to reveal the concentration of fluid in the joint.
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Radionuclide diagnostics. An effective method for identifying the disease at the initial stage. With its help, zones of distribution, the level of development of pathology are detected. An accurate diagnosis on the first day of spinal osteomyelitis is possible.
- Fistulography. The method is the introduction of a contrasting element into the bone, followed by displaying the image on a monitor. The survey clarifies the nature of the pathology, contributes to the assessment of the prevalence level, and is characterized by high accuracy.
- Microbiological research. To diagnose the causative agent of the disease, a biopsy is performed, followed by a microbiological examination. The accuracy of the procedure results is about 75%.
Spinal osteomyelitis treatment
Conservative treatment
Acute osteomyelitis of the spine is an indication for the patient to stay in bed. Special beds make the condition easier, ensuring the correct position of the body. The average duration of bed rest is three months, the time is needed to bring the ESR back to normal.
External immobilization is indicated to stabilize the spine, prevent deformity (observed in approximately 30% of patients), and reduce the intensity of pain attacks. Osteomyelitis of the spine often develops against the background of another infectious disease. He is being treated in parallel.
Antibiotic treatment is mandatory. First of all, it is penicillin, which controls the spread of pathology. With the help of penicillin, you can stop pathological destruction of bone tissue if the drug is taken in the first days of infection. From about the second week, the effectiveness of antibiotics decreases. The results of conservative therapy are monitored using clinical tests.
Operative treatment
The first 6-24 months after the patient has the first signs of pathology, there are high chances of cure without surgery. According to statistics, radical intervention is necessary only in 10-20% of cases.
The operation is performed in the most difficult situations. The main purpose of the intervention is cleansing and surgical treatment of wounds, elimination of dead tissue, and drainage.
Physiotherapy procedures
By the decision of the doctor, the patient can be prescribed physiotherapy exercises, which has a general tonic effect, stimulates the affected part of the body, contributing to the restoration of functions. It is also possible to carry out electrophoresis, laser therapy, magnetotherapy.
The prospect of a complete recovery depends on such moments as the time of initiation of treatment, the severity of the spread of the process, the age of the patient.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
