Abstract
The global increase of spinal infections is concomitant with the rise of its risk factors, including HIV/AIDS, diabetes mellitus, intravenous drug use, advanced age, and gunshot wounds to the spine. Because spinal infections have a wide span of presentation, early detection and differentiation are notoriously challenging. Current advances in laboratory and imaging techniques, such as polymerase chain reaction, fluorodeoxyglucose positron emission tomography, and 99mTc-ciprofloxacin scintigraphy, allow for better diagnostic rendering of the infection and its degree of spinal involvement. Less invasive surgical procedures and preventive surgical management have helped reduce spinal infection morbidities such as deformity and neurologic deficit. Although proper antibiotic regimen and correct surgical management are of vital importance to successful patient outcome, early detection remains the most critical factor.
Similar content being viewed by others
References and Recommended Reading
Tandon N, Vollmer DG: Infections of the spine and spinal cord. In Youmans Neurological Surgery, Fifth edition. Edited by Winn HR. Pennsylvania: Press; 2004:4363–4394.
Quiñones-Hinojosa A, Jun P, Jacobs R, et al.: General principles in the medical and surgical management of spinal infections: a multidisciplinary approach. Neurosurg Focus 2004, 17:E1. This review article clearly delineates background with regard to infections of the spine, as well as current management and surgical techniques.
Acosta FL, Chin CT, Quiñones-Hinojosa A, et al.: Diagnosis and management of adult pyogenic osteomyelitis of the cervical spine. Neurosurg Focus 2004, 17:E2.
Pigrau C, Almirante B, Flores X, et al.: Spontaneous pyogenic vertebral osteomyelitis and endocarditis: Incidence, risk factors, and outcome. Am J Med 2005, 1287:17–24.
Cunningham ME, Girardi F, Papadopoulos EC, et al.: Spinal infections in patients with compromised immune systems. Clin Orthop Relat Res 2006, 444:73–82.
Hsieh PC, Wienecke RJ, O’Shaughnessy BA, et al.: Surgical strategies for vertebral osteomyelitis and epidural abscess. Neurosurg Focus 2004, 17:E4.
Tsiodras S, Falagas, ME: Clinical assessment and medical treatment of spine infections. Clin Orthop Relat Res 2006, 444:38–50.
Choll WK, Perry A, Currier B: Fungal infections of the spine. Clin Orthop Relat Res 2006, 444:92–99.
Masuda T, Miyamoto K, Hosoe H, et al.: Surgical treatment with spinal instrumentation for pyogenic spondylodiscitis due to methicillin-resistant Staphylococcus aureus (MRSA): a report of five cases. Arch Orthop Trauma Surg 2006, Epub ahead of print.
Wang D: Diagnosis of tuberculous vertebral osteomyelitis (TVO) in a developed country and literature review. Spinal Cord 2005, 43:531–542.
Schlesinger N, Lardizabal A, Rao J, et al.: Tuberculosis of the spine: experience in an inner city hospital. J Clin Rheumatol 2005, 11:17–20.
Swanson AN, Pappou IP, Cammisa FP, et al.: Chronic infections of the spine. Clin Orthop Rel Res 2006, 444:100–106. This recent article is an excellent source of detailed and general information encompassing the scope and management of persistent spinal infections.
Bono CM: Spectrum of spine infections in patients with HIV. Clin Orthop Relat Res 2006, 444:83–91.
Weinstein MA, Eismont FJ: Infections of the spine in patients with human immunodeficiency virus. J Bone Joint Surg Am 2005, 87:604–609.
Quigley KJ, Place HM: The role of debridement and antibiotics in gunshot wounds to the spine. J Trauma 2005, 60:814–820.
Pui MH, Mitha A, Rae WI, et al.: Diffusion-weighted magnetic resonance imaging of spinal infection and malignancy. J Neuroimaging 2005, 15:164–170.
Chang MC, Wu HT, Lee CH, et al.: Tuberculous spondylitis and pyogenic spondylitis: comparative magnetic resonance imaging features. Spine 2006, 31:782–788.
James SL, Davies AM: Imaging of infectious spinal disorders in children and adults. Eur J Radiol 2006, 58:27–40.
Falagas ME, Valotassiou VJ, Papadouli D: 99Technetiumcipro floxacin scintigraphy for the evaluation of spinal infections. Clin Orthop Relat Res 2006, 444:34–37.
Stumpe KD, Zanetti M, Weishaupt D, et al.: FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR Am J Roentgenol 2002, 179:1151–1157.
Kobayashi N, Bauer T, Togawa D: A molecular gram stain using broad range PCR and pyrosequencing technology. Diagn Mol Pathol 2005, 14:83–89.
An HS, Seldomridge JA: Spinal infections: diagnostic tests and imaging studies. Clin Orthop Relat Res 2006, 444:27–33.
Siddiq F, Chowfin A, Tight R, et al.: Medical vs surgical management of spinal epidural abscess. Arch Intern Med 2004, 164:2409–2412.
Kohshi K, Abe H, Mizoguchi Y, et al.: Successful treatment of cervical spinal epidural abscess by combined hyperbaric oxygenation. Mt Sinai J Med 2005, 72:381–384.
Muckley T, Shutz T: The role of thorascopic spinal surgery in the management of pyogenic vertebral osteomyelitis. Spine 2004, 29:E227-E233.
Savage K, Holtom PD, Zalavras CG: Spinal epidural abscess: early clinical outcome in patients treated medically. Clin Orthop Relat Res 2005, 439:56–60.
Grewal S, Hocking G, Wildsmith JA: Epidural abscesses. Br J Anaesth 2006, 96:292–302.
von Stechow D, Scale D, Rauschmann MA: Minimizing the surgical approach in patients with spondylitis. Clin Orthop Relat Res 2005, 439:61–67.
Christodoulou AG, Givissis P, Karataglis D, et al.: Treatment of tuberculous spondylitis with stabilization and titanium cage. Clin Orthop Relat Res 2006, 444:60–65.
Nakase H, Tamaki R, Matsuda R: Delayed reconstruction by titanium mesh-bone graft composite in pyogenic spinal infection: a long-term follow-up study. J Spinal Disord Tech 2006, 19:48–54.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Acosta, F.L., Galvez, L.F., Aryan, H.E. et al. Recent advances: Infections of the spine. Curr Infect Dis Rep 8, 390–393 (2006). https://doi.org/10.1007/s11908-006-0050-4
Issue Date:
DOI: https://doi.org/10.1007/s11908-006-0050-4