Infection may be caused by bacterial or fungal organisms and may occur after surgery. Most postoperative infections occur three days to three months after surgery. Spinal infections can be classified depending on the anatomical location:
Infections of the spine;
Infections between the spinal disc;
Infections in the spinal canal;
Infections in adjacent soft tissues infections;
Vertebral osteomyelitis is the most common form of vertebral infection. It can develop directly from an open spinal injury, surrounding infections, and bacteria that have spread to the vertebrae.
Intervertebral disc infections involve the area between adjacent vertebrae. Disc space infections can be divided into three subcategories: adult hematogenous (spontaneous), infant (discitis), and postoperative.
Infections of the spinal canal is an infection that develops around the dura (surrounding the spinal cord and nerve root contains tissue). Subdural abscess is much rarer and affects the potential space between the dura and the arachnoid (spinal membrane, between the dura mater and pia mater). Infections in the spinal parenchyma (primary tissue) are called intramedullary abscesses.
Adjacent soft tissue infections. Soft tissue infections usually affect young patients and are not common in the elderly.
FREQUENCY
Spinal osteomyelitis affects approximately 26,170 to 65,400 people per year.
Epidural abscess. It is rare, affecting only 0.2 to 2 cases for every 10,000 hospital admissions. However, 5 to 18 percent of patients with disc space caused by vertebral osteomyelitis or adjacent spread will develop an epidural abscess.
Some studies show an increased frequency of spinal infections. This jump may be related to the increased use of vascular devices and other forms of devices and increased use of intravenous medications.
Approximately 30-70% of patients with vertebral osteomyelitis are not apparent before infection.
Epidural abscess. It can occur at any age, but is most common in people aged 50 and over.
Spine infection Risk factors for ion include conditions that compromise the immune system:
Advancing age;
Intravenous use of the drug;
Human immunodeficiency virus infection (HIV);
Long-term systematic use of steroids;
Diabetes;
Organ transplantation;
Nutrition disorder;
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Cancer;
Surgical risk factors include long-term surgery, high blood loss, use of apparatus, and repeated or revision surgeries at the same site. Infections occur in 1-4% of surgical cases, despite numerous subsequent preventive measures.
CAUSES
Spinal infections can result from a bacterial or fungal infection in another part of the body that is carried to the spine through the bloodstream. The most common source of spinal infections is a bacteria called Staphylococcus aureus, followed by Escherichia coli.
Spine infections can occur after a urological procedure because the veins at the bottom of the spine run through the pelvis. The most common area of the spine affected is the lumbar area. Intravenous addicts are more prone to infections affecting the cervical region.
Intervertebral disc infections likely begin in one of the adjacent end plates, and the disc becomes secondarily infected. There are some contradictions regarding the origin of children. In children, most cultures, biopsies are negative, and experts believe that juvenile discitis may not be an infectious condition but is caused by partial displacement of the pineal gland (the area of growth near the bone end) as a result of darkening.
SYMPTOMS
Symptoms vary depending on the type of spinal infection, but in general the pain is initially localized at the site of infection. These additional symptoms may be present in postoperative patients:
Mucus drainage wound
Redness, swelling, or tenderness
Treatment of vertebral osteomyelitis
Strong back pain
chills
Heaviness
Muscle cramps
Painful or difficult urination
Dislocation of neurological deficits
Intervertebral disc infections
At first patients may have minimal symptoms, but eventually they develop severe back pain. Generally, young children do not have a fever but suffer from malaria. Children between the ages of 3 and 9 often have back pain as a predominant symptom.
Disc space infection occurs one month after surgery. Pain is usually relieved from bed mode and immobilization, but increases with movement. If left untreated, the pain gets worse and is immune, not even responding to pain medications.
Spinal canal infections
Adult patients It usually progresses through the following clinical stages:
Severe back pain with fever and local pain in the spine
Pain in nerve roots originating from the infected area
Muscles weakness and bowel/bladder dysfunction
Paralysis
The most obvious symptoms in children are prolonged crying, significant pain in the palpation area, and hip pain.
Adjacent soft tissue infections
In general, symptoms are often nonspecific. If a paraspinal abscess is present, the patient may have hip pain, abdominal pain, or lameness. If there is a muscle abscess, the patient may feel radiating pain in the hip or thigh area.
DIAGNOSIS
The biggest problem is early onset of a serious incidence. is to diagnose. Diagnosis usually takes an average of one month, but can take up to six months, hindering effective and timely treatment. Many patients do not seek medical attention until symptoms become severe or weakening.
Laboratory tests
Specific laboratory tests are used to diagnose spinal infection. It may be useful. It may be helpful to have blood tests for the acute protein phase, red blood cell sedimentation rate (ESR), and C-reactive protein (CPR) levels. Both ESR and SRP tests are generally good indicators of whether there is any inflammation in the body (the higher the level, the more likely inflammation is). However, these tests are limited and other diagnostic tools are often required.
Body identification is important and this can be obtained by biopsy via computed tomography of the spine or disc area. during fire a preferably taken blood cultures can also help identify the pathogen involved in spinal infections.
Imaging tools
To determine the location and extent of defeat Image studies are required for Choosing specific imaging modalities depends on the location of the infection. Soft tissue involvement is best determined by magnetic resonance imaging, while the degree of destruction of bone tissue is best adjusted by computer tomography scanning.
TREATMENT
Nonsurgical treatment
Spinal infections often require long-term intravenous antibiotic or antifungal therapy and can equal long-term hospitalization for the patient. Immobilization may be recommended when there is significant pain or potential for spinal instability. If the patient is neurologically and structurally stable, antibiotic therapy should be administered once the body has caused a properly detected infection. Patients usually undergo antimicrobial therapy for at least six to eight weeks. The type of medication is determined in each case depending on the specific circumstances, including the age of the patient.
Surgical treatment
Patients should at least with no or no neurological deficit, nonsurgical treatment should be considered first, and the incidence and mortality rate of surgical intervention is high. However, surgical intervention may be indicated when any of the following conditions occur:
affects the bones;
Neurological deficit;
Abscess, reaction to antibiotics Amniotic sepsis with clinical toxicity that does not cause;
No needle biopsy to obtain the necessary plants;
Lack of intravenous antibiotics to eliminate the infection;
The goals of the operation are:
Clear (clean and remove) infected tissue ;
Ensures infected tissue receives proper blood flow to aid in healing;
Maintains spinal stability to protect or repair;
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