Cervical discitis is a disease in which there is inflammation of the vertebral disk space. This inflammation is caused by an infection that has traveled from other parts of the body to the spinal column through the blood stream. It is very uncommon for the infection to start in the disk space. Discitis is not a very common disease, it will usually only affect 1 in every 100,000 people with death happening in only 2 to 12% of those affected. Death is usually a result of the spreading infection through either the nervous system or the organs. Discitis can affect both males and female but will affect males more often in usually a 2:1 ratio. Discitis can affect both children and adults but does not affect one race more than another
In adults this disease progresses very slowly which can cause the diagnosis to be delayed for months. Most individuals have beginning complaints of tenderness and or pain in the neck or back. In those individuals that are already chronically ill, there will be a higher occurrence of epidural extension of the infection. This can cause those individuals to have weakness in their legs and feet. Patients who have just had surgery will have symptoms similar to those with an acute discitis but can expect their symptoms to appear within a day or two after having surgery. IN some cases of post op discitis the symptoms may not appear for a week or two. In children the disease will present itself much faster. The more common symptoms are sudden back pain, irritability and possibly the child refusing to walk. In both children and adults there have also been instances of fever and chills being reported. In most cases the most common physical symptom is having tenderness over the affected area and spasms of the paraspinal muscles
Discitis is usually caused by the spread of infection through the blood stream from a systemic infection such as a kidney infection. The most common infections to cause discitis are pneumonia, soft tissue infections and urinary tract infections. This type of disk infection has also been known to be caused by an infection at the site of a surgical procedure of the spine such as a discectomy. However infections caused by this a very rare, usually only resulting in about .5% of cases.
Because of its slow progression it can be difficult to diagnose discitis in its early stages. X-ray can be used to diagnose discitis by showing the narrowing of the disk space but this is only after the disease has been present for weeks. CT scans are able to identify discitis earlier by highlighting the decrease in the density of the disk itself. The best way of detecting discitis is the use of MRI. BY using a T-1 weighted image, an MRI has the ability to show the narrowing of the disk space and the edema associated with the infection. MRI will also help the technologist to distinguish between an infectious discitis and other pathologies such as tuberculosis.
In some cases the doctor will do a biopsy using a needle to determine if the disease is discitis or something more. In other cases surgical biopsy may be used because it is believed by some to be a more conclusive way of diagnosing discitis. Treatment of discitis is the use of an antibiotic to keep the infection from spreading. I.V. antibiotics are the best course of action and they are given for around six to eight weeks. During the first few weeks of treatment it is recommended that the patient be on bedrest. After this period of bedrest the patient should have external immobilization in pace in the form of a brace. This bracing will allow the vertebrae that are affected to fuse in an aligned position. The patient must wear this brace for a period of 3 to 6 months. If all treatment steps are followed most discitis cases will be resolved. In rare cases (usually only 15%) permanent neurological deficits may occur. The image I have below is a T-1 wieghted image showing discitis of the lumbar spine.
In adults this disease progresses very slowly which can cause the diagnosis to be delayed for months. Most individuals have beginning complaints of tenderness and or pain in the neck or back. In those individuals that are already chronically ill, there will be a higher occurrence of epidural extension of the infection. This can cause those individuals to have weakness in their legs and feet. Patients who have just had surgery will have symptoms similar to those with an acute discitis but can expect their symptoms to appear within a day or two after having surgery. IN some cases of post op discitis the symptoms may not appear for a week or two. In children the disease will present itself much faster. The more common symptoms are sudden back pain, irritability and possibly the child refusing to walk. In both children and adults there have also been instances of fever and chills being reported. In most cases the most common physical symptom is having tenderness over the affected area and spasms of the paraspinal muscles
Discitis is usually caused by the spread of infection through the blood stream from a systemic infection such as a kidney infection. The most common infections to cause discitis are pneumonia, soft tissue infections and urinary tract infections. This type of disk infection has also been known to be caused by an infection at the site of a surgical procedure of the spine such as a discectomy. However infections caused by this a very rare, usually only resulting in about .5% of cases.
Because of its slow progression it can be difficult to diagnose discitis in its early stages. X-ray can be used to diagnose discitis by showing the narrowing of the disk space but this is only after the disease has been present for weeks. CT scans are able to identify discitis earlier by highlighting the decrease in the density of the disk itself. The best way of detecting discitis is the use of MRI. BY using a T-1 weighted image, an MRI has the ability to show the narrowing of the disk space and the edema associated with the infection. MRI will also help the technologist to distinguish between an infectious discitis and other pathologies such as tuberculosis.
In some cases the doctor will do a biopsy using a needle to determine if the disease is discitis or something more. In other cases surgical biopsy may be used because it is believed by some to be a more conclusive way of diagnosing discitis. Treatment of discitis is the use of an antibiotic to keep the infection from spreading. I.V. antibiotics are the best course of action and they are given for around six to eight weeks. During the first few weeks of treatment it is recommended that the patient be on bedrest. After this period of bedrest the patient should have external immobilization in pace in the form of a brace. This bracing will allow the vertebrae that are affected to fuse in an aligned position. The patient must wear this brace for a period of 3 to 6 months. If all treatment steps are followed most discitis cases will be resolved. In rare cases (usually only 15%) permanent neurological deficits may occur. The image I have below is a T-1 wieghted image showing discitis of the lumbar spine.
My information and image came from the following website
http:www.emedicine.com/Orthoped/topic77.htm
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