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| Spinal
Infection |
Though infections and inflammation
of the spine are rare, if they are neglected for
a period of time, or if there is a delay in diagnosis,
they can become a significant source of pain and
disability. Bone and joint infections anywhere in
the body can be crippling and life threatening.
Discitis is a low-grade
infection that affects the disc space between
two vertebrae. Although discitis is uncommon,
children under ten are usually the ones affected
by this condition which is the result of an inflammation
caused by staphylococcus, viruses, or other inflammatory
processes. Discitis is characterized by the slow
onset of severe back pain and may or may not be
associated with fever, chills, sweats, feeling
tired, loss of appetite or other symptoms. The
diagnosis is usually made by seeing narrowing
of the disc space between two vertebrae and a
bone scan that shows that the disc and adjacent
vertebrae are "hot" on the scan. This condition
can be very painful and is often aggravated by
any movement of the spine. The pain often travels
to other parts of the body including the abdomen,
hip, leg, or groin. It usually occurs in the lower
(lumbar) back and upper (thoracic) back. Though
Young children with this
condition are usually irritable and uncomfortable
and refuse to sit up, stand or walk. The treatment
of discitis generally involves antibiotics, rest,
and a brace. Surgery is rarely needed.
Ankylosing spondylitis
is a rare condition that can cause back and neck
pain. It is a rheumatic inflammatory disease that
affects the spine and sacroiliac joints. Although
it primarily attacks the spine (usually the low
back first), this chronic and painful disease
can also attack other joints, tendons and ligaments,
and the chest wall.
Over time, this disease
can cause the vertebral bodies in the spine to
fuse together. When this happens, patients with
ankylosing spondylitis can have difficulty moving
freely. Common symptoms for ankylosing spondylitis
are gradually occurring back pain and stiffness
(usually over a period of weeks or months). Early
morning stiffness is often helped with a warm
shower or light exercise. Symptoms last longer
than three months.
In particularly severe
cases, patients may be unable to look above the
level of the horizon, or they may develop a significant
amount of pain from having a hunched over posture.
Ankylosing spondylitis is usually diagnosed using
x-rays of the sacroiliac joints, looking for changes
in the tissues caused by inflammation. However,
tissue changes are not always visible.
ain
that is worse with strenuous exercise or activity.
Radiographic findings are subtle, but bone scans
or CT scans will usually detect the lesion. Activity
modification, bracing, or surgical treatment may
be indicated for persistent symptoms.
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