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Spinal Cord Infection Treatment

Prompt spinal cord infection treatment is essential in the prevention of serious complications.

Antibiotic medications are often used in spinal cord infection treatment. [©Shutterstock, 2010]
©Shutterstock, 2010
Antibiotic medications are often used in spinal cord infection treatment.

Spinal Cord Infection Treatment

Proper spinal cord infection treatment is vital to prevent serious complications like paralysis. While such dire consequences are extremely rare, a spinal cord infection can still be a potentially dangerous condition. Before examining the proper treatment for a spinal cord infection, however, it is important to understand what causes these infections and the various types of infection that can occur.

Causes of Spinal Cord Infection

Spinal cord infections are generally caused by bacteria, fungus, or a virus. The majority of spinal cord infections are caused by the bacteria staphylococcus, or what is commonly referred to as a "staph infection." Spinal cord infections can be dangerous because of the crucial role the spinal cord plays in the body.

The most dangerous aspect of spinal cord infection is the possibility of a spinal abscess. Part of the body's response to an infection is to produce pus to eliminate the infecting bacteria. When pus is produced in an enclosed area of the body (such as the spinal column) it is called an abscess. If a spinal abscess becomes large enough, it can press against the spinal cord and impair neurological function, though it bears repeating that this is a very rare complication.

Occasionally, spinal cord infections are simply caused by an infection elsewhere in the body, and are transmitted to the spine through the blood stream. Another major cause of a spinal infection is an infection at the site of recent back surgery, such as a lumbar puncture (where a needle is injected into the spine). The North American Spine Society estimates that only 4 percent of back surgeries will result in an infection. Certain chronic conditions like intravenous drug use, alcoholism, HIV or diabetes may also predispose a patient towards contracting an infection. Spinal cord infections in children have a strong association with congenital defects of the spinal canal.

Types of Spinal Infections

The various types of spinal infections are classified by the portion of the spine they affect. There are four main types:

  • Vertebral osteomyelitis: While the American Association of Neurological Surgeons describes this as the most common form of spinal infection, they estimate that it only affects around 1perecent of the American population. Vetebral osteomyelitis is essentially an infection in the bones of the spine (vertebrae).
  • Interverebral disc space infection: This infection, as the name implies, happens between the vertebrae in the spinal column.
  • Spinal canal infections: These infections occur in the area around the spinal cord and are the most likely to cause an abscess.
  • Adjacent soft-tissue infections: Again, as the name would lead you to believe, these infections affect areas around the spine, such as the muscles of the back.

Symptoms of Spinal Cord Infection

A spinal cord infection can produce symptoms that vary widely in frequency and severity. These most often include chills, fever, headaches, neck stiffness and pain. A wound resulting from injury or surgery may appear red, feel tender and start to swell. Common neurological symptoms include numbness, weakness and tingling in the extremities.

In the rare case of a spinal abscess, a physical examination may show well-defined areas of pain without an obvious cause. Motor deficits usually progress from a slight weakness of a limb to paralysis below the level of the infection. Difficulties with sphincter (circular muscles that aid digestion) control may also develop, causing a loss of control over urine flow and bowel movements.

Diagnosis of Spinal Cord Infection

There are many ways to diagnose a spinal infection that are usually used in concert to access the presence of an infection and then pinpoint exactly what part of the spine has become infected.

A doctor will request a laboratory test to determine if the area surrounding the spine has become infected. Initially the patient will undergo a general blood test to detect inflammation in the body. If an infection is found, a biopsy of the vertebrae or a lumbar puncture will be performed so that the type of infection can be ascertained.

Depending on the type of infection, a doctor will next order an X-Ray, CAT (computed tomography) scan, or MRI (magnetic resonance imaging) to pinpoint where the infection is located. Once the type and location of the infection has been confirmed, treatment can begin.

Treatment of Spinal Cord Infection

The typical first stage of treatment for a spinal cord infection is a course of antifungal or antibiotic medications. Treatment may last for 6 weeks or more and require extended hospitalization. Corticosteroids may also be prescribed to treat spinal cord swelling.

If drug therapies fail to treat the infection or if a patient is facing the threat of serious neurological damage, surgical options may be explored. The objective is a spinal surgery would obviously be to remove the infected tissue or, in rare cases, to prevent damage to the spine (as would be caused by an abscess). Once again, with the advancements in antibiotics, it is very rare for a spinal infection to require surgery.

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