Osteomyelitis of the spine

Osteomyelitis of the spine is a very dangerous infection of the bone tissue, which requires urgent and long-term treatment. Pathology of the spine are considered the most severe lesions of the bone in view of the complex structure of the ridge, the close proximity of the bone marrow and the location of the main nerve endings. Any breach in its structure very often affects the internal organs, blood flow, nerve sensitivity and in some cases can threaten the patient’s life. Osteomyelitis of the spine is characterized by a severe inflammatory process that affects all parts of bone: spongy, periosteum, bone marrow, etc.

Diagnosed with two diseases: nonspecific and specific osteomyelitis. The nonspecific form is called pyogenic infectious agents: Staphylococcus aureus, Escherichia coli and various fungi. Specific osteomyelitis is a consequence of the development of such diseases as tuberculosis of the bones, syphilis, brucellosis, etc. with the progression of the disease completely destroys the areas of the spine and bone marrow.Остеомиелит позвоночника


The causes of the disease

Osteomyelitis develops as a result of lesions of the spine different types of infection. Initially, the bone tissue of a healthy body has a high tolerance to infectious pathogens is a kind of barrier that inhibits pathogenic micro-organisms and prevents their reproduction. The development of osteomyelitis is caused by processes which lower the resistance of the spine to infection by creating favorable conditions for the destruction of bone tissue.

There are several obvious circumstances that in varying degrees can cause the development of osteomyelitis.

  • Osteomyelitis of the knee, elbow and other joints and bones. Infectious lesions of the knee and other joints may likely to cause osteomyelitis of the spine. The location of the infectious focus is not decisive, since the infection is transmitted by hematogenous route, i.e., through the bloodstream. The development of osteomyelitis of the spine may, equally likely, to contribute as osteomyelitis of the hip joint and damage to the knee or elbow.
  • Infectious foci. Under appropriate conditions, source of infection of the bone tissue of the spine can serve any remote infectious focus. Caries, tonsillitis, cellulitis, boils in the region of the knee joint or in any other place, and other diseases of infectious nature, which at first glance have no relation to the spine, create the risk of transmitting infectious agent hematogenous route.
  • Injury. Deep fractures, gunshot wounds of the spine and surgery for syringomyelia or other diseases of the spinal cord create the risk of osteomyelitis due to infection in the bone tissue.
  • A serious infectious disease. Such diseases as syphilis, tuberculosis of bones, etc. at the last stage cause damage to bone tissue. In this case, characterized by multiple bone lesions – knee, hip joints, spine, etc.
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    Osteomyelitis, regardless of the causes, develops on the background of weakening of the immune system, and its duty which is to protect the body from infection. The more weakened the immune system, the more intense will be the growth of pathogenic microorganisms trapped in the bone tissue.

    The greatest risk of developing osteomyelitis create autoimmune diseases, AIDS, etc. In this category also includes drug usage, alcohol abuse, Smoking and other circumstances adversely affecting immunity.


    Clear symptoms

    Osteomyelitis of the spine is characterised by two conditions – acute and chronic, depending on which are determined by the manifestations of the main symptoms. As a rule, at the initial stage the disease has an acute or subacute course with a distinct pattern of symptoms. At a favorable outcome the body is completely cured, in adverse pathology becomes chronic. If the cause of the development of osteomyelitis was such diseases as syphilis, tuberculosis, etc., acute phase of the disease is not diagnosed, that is, the disease initially has a primary chronic course.

    Остеомиелит позвоночникаLesions of the spine is characterized by similar to osteomyelitis of the knee, elbow, etc. symptoms.

    Symptoms

    Clinic

    Fever. The inflammatory process causes a General/local increase in body temperature up to 40 degrees Celsius. The fever may be accompanied by fever, loss of consciousness, delirium.
    Intoxication. The acute course of the disease implies severe intoxication: bacteria poison the body, significantly worsening his condition. The level of intoxication can reach up to acute sepsis – blood poisoning.
    Pain. Pain is most often localized directly in the area of the lesion is the cervical, lumbar, thoracic, etc. the Pain is sharp, intense, bursting or tearing sensations, which are aggravated by motion. With chronic pain can be aching or throbbing.
    Numbness. During the chronic nerve damage can lead to numbness, loss of sensitivity of the site, which is «attached» to the corresponding spine. For example, the sciatic nerve passes through the sacral region of the spine, hip region and knee joints – the effects of the disease may occur throughout the nerve fibres.
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    Depending on the cause and nature of the development of the disease the above symptoms can be manifested with different intensity. Diagnosis of osteomyelitis of the spine is performed solely on an outpatient basis. This is done by radiography, computed tomography, ultrasound.

    Because of the high risk of development of blood poisoning, septic arthritis, malignant transformation of tissues, amyloidosis of kidneys, acute heart failure and other dangerous complications is important to diagnose osteomyelitis in the early stages of the disease.


    Similar diseases

    Accurately diagnose osteomyelitis of the spine in most cases is difficult, especially when it comes to chronic disease. When lesions of the spine is the differential diagnosis by which defines the terms most suitable for symptoms of diseases. The closest to osteomyelitis disorders are:

    • hydromyelia;
    • syringomyelia.

    They often complicate the formulation of the true diagnosis. Hydromyelia is a congenital disease, which resulted in a spinal cord are formed channels filled with liquid. Syringomyelia is characterized by formation of ever-growing cavity in the spinal cord.

    Остеомиелит позвоночникаMost hydromyelia does not bring any noticeable inconvenience. Its presence show only myelography spine x-rays and other examination methods. During the examination, hydromyelia may be cause for suspected osteomyelitis, so as to visually determine what is in the channel – pus or fluid, is quite difficult. The primary diagnosis of this disease is also differentialsa with syringomyelia. Only after the puncture of the spine and laboratory fluid analysis, the exact diagnosis: osteomyelitis or hydromyelia.

    Syringomyelia is a congenital progressive disease and is characterized by pronounced symptoms that have similarities with the manifestations of chronic osteomyelitis. Syringomyelia causes the formation of cavities in the spinal cord, which, as the growth begins to squeeze the nerve endings. Also may be affected by the medulla oblongata, if the affected cervical. Syringomyelia is manifested by loss of thermal and pain sensitivity, pain and numbness in various areas of the body.

    The symptoms of syringomyelia are characteristic manifestations of chronic osteomyelitis in remission. As a fluid-filled cavity, during the initial examination of syringomyelia can also contribute to inaccuracies in diagnosis.


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    Treatments

    Osteomyelitis of the spine, unlike syringomyelia or hydromyelia, is not a congenital disease and in most cases treatable. For the treatment of acute stage is a massive antibacterial therapy with the mandatory accounting task force of the infectious pathogen. Also performed drainage of the suppurative focus with subsequent washing of the cavity with antibacterial solutions. To fill the amount of blood and cleanse the body of toxins can be applied to transfusion plasma, purification, absorbtion, and other activities to improve the composition of blood. All the stages of treatment must be performed on an outpatient basis under the supervision of a physician.

    In 70% of cases above measures lead to full recovery. Tissue repair prevails over destruction, foci of necrosis are gradually replaced with full flesh. If the disease were diagnosed in the advanced form, the possible adverse outcome when acute osteomyelitis becomes chronic. The chronic form of the disease characterized by periods of exacerbation and remission, during which the disease manifests itself is weak or almost does not occur.

    Full recovery from chronic osteomyelitis is only possible after the surgical intervention through which removes lots of dead and changed tissue.