DISCITIS

Questions and Answers

Diagnosis

Diagnosing Discitis uses a multi-pronged approach to confirm infection and find its origin. Here’s an overview:

• Medical history and physical examination: The doctor asks about symptoms, duration, and risk factors like recent infections or trauma. A physical exam checks pain location, tenderness, and mobility.
• Imaging tests: X-rays initially rule out causes like fractures, but may miss early Discitis signs. Magnetic resonance imaging (MRI) with contrast dye sets the gold standard. It reveals inflammation and fluid around the affected disc.
• Blood tests: Blood tests don’t confirm Discitis, but check infection signs like elevated white blood cell count and C-reactive protein levels.
• Biopsy: In rare cases, a needle biopsy of the infected disc space confirms the diagnosis. It identifies the specific organism, guiding targeted antibiotic treatment.

Doctors combine these methods to diagnose Discitis effectively. This approach prevents long-term complications.

Bone Scans in Diagnosing Discitis

Bone scans help find discitis when other imaging tests remain unclear. This test puts a small trace of radio stuff into a vein. The trace moves through the blood and builds up in spots with high bone work. Germs or swell can spark this build.

You lie on a scan bed for the test. A special cam finds and shows where the radio trace sits in your bones. Spots with a strange build hint at germs in the spine or disc space. Bone scans lack MRI’s sharp read for discitis. They still give good clues on bone health and mark swell spots.

Risk Factors

Risk signs for discitis include old age and weak body guard due to health issues like sugar (diabetes) or HIV. Other risk signs are new spine surgery and use of vein drugs. People with weak bodyguards or who catch bugs easily face a greater risk of discitis.

More risk comes with bodyguard flaws, healing from surgery, or vein drug use. Kids under 10 are more prone to discitis than grown-ups.

By knowing these risk signs, folks and caregivers can watch for early signs and seek quick care if needed.

Non-surgical Treatment Options

Non-surgical treatment options for discitis may include rest, pain management, antibiotics, or antifungal medications if an infection is present.  Physical therapy is often recommended to improve mobility and strengthen the spine. Physical therapy recommendations often focus on exercises to improve posture, strengthen core muscles, and increase flexibility in the spine to reduce the risk of recurrence and improve overall function.  In severe cases or when conservative measures fail, doctors will recommend surgery to remove infected tissue or stabilize the spine.

When is Surgery Considered for Discitis?

Surgery for discitis is generally reserved for situations where conservative treatments have failed or when complications develop. Most individuals respond well to a combination of antibiotics or antifungal medications, rest, pain management, and physical therapy. However, surgical intervention may become necessary if:

• There is significant destruction of the intervertebral disc or nearby bone that threatens spinal stability.
• The infection led to the formation of an abscess compressing the spinal cord or nerves, resulting in neurological symptoms such as weakness, numbness, or loss of bowel or bladder control.
• Persistent pain or worsening symptoms continue despite appropriate medical therapy.
• There is a failure to control the infection with medications, as evidenced by ongoing fever, elevated inflammatory markers, or spreading infection.

Surgical procedures may involve removing infected material, draining abscesses, stabilizing the spine with instrumentation, or reconstructing areas damaged by the infection. The goal of surgery is to reduce pain, restore spinal stability, and prevent further neurological complications. For many patients, this step is only required in severe or complicated cases, and after all other treatments have failed.

What should you do if your symptoms of discitis return or worsen after treatment?

If your symptoms come back or become more severe after initial treatment for discitis, it’s essential to follow up with your healthcare provider as soon as possible. Persistent or worsening pain could signal that the infection still exists or that complications have developed.

Your doctor may need to reassess your condition using additional imaging studies or adjust your treatment plan, which could involve changing medications, extending your antibiotic course, or considering further interventions. Don’t ignore new or escalating symptoms, as early intervention can prevent serious complications and support a smoother recovery. Keep track of your symptoms, communicate openly with your care team, and seek prompt medical attention for any concerning changes.

Complications of Discitis

Even though Discitis is left untreated or complications arise, doctors can usually treat the condition successfully. If continued non-treatment, it can lead to several long-term issues. These potential complications include:

• Disc damage: The infection can damage the intervertebral disc, causing its degeneration and loss of height. This can lead to chronic pain, instability in the spine, and increased risk of future disc herniation.
• Spinal deformity: If the disc damage is significant, it can affect the alignment of the spine, leading to conditions like kyphosis (hunchback) or scoliosis (curvature of the spine).
• Nerve compression: Discitis can cause inflammation around the spinal cord and nerve roots, leading to pain, numbness, weakness, and even paralysis in severe cases.
• Epidural abscess: In rare instances, the infection can spread beyond the disc and involve the surrounding tissues.
• Sepsis: In severe and neglected cases, the infection can enter the bloodstream and cause a life-threatening response known as sepsis.
• Ongoing or Chronic Back Pain: Although uncommon, some people may develop persistent or recurring back pain even after the initial infection resolves.
• Medication Side Effects: Antibiotics or antifungal medications, commonly prescribed for discitis, may cause side effects. For example, stomach upset, allergic reactions, or, in rare cases, more serious issues like kidney or liver problems.
• Recurrent Infections: If the infection is not fully eradicated or if the underlying immune system problem persists, discitis may return or become a chronic problem.
• Complications from Autoimmune Issues: In cases where discitis is linked to autoimmune conditions rather than infection, doctors may need to consider long-term management.

Early diagnosis and treatment of Discitis are crucial to prevent these complications and ensure a full recovery. If you experience back pain, fever, or difficulty walking, especially in children, it’s important to seek medical attention promptly.

Prevention Actions for Discitis

Prevention actions for discitis include practicing good hygiene, avoiding high-risk behaviors such as intravenous drug use, and maintaining a healthy lifestyle to support the immune system. Similarly, related conditions may include spinal infections, vertebral fractures, and degenerative disc disease, which can share similar symptoms and treatment approaches. Discitis often accompanies another medical condition called osteomyelitis—an infection with inflammation of the bone or bone marrow.

Because these conditions frequently overlap, it is important for both patients and healthcare providers to know that symptoms such as persistent back pain, fever, or decreased mobility could indicate more than one underlying issue. Early detection and a comprehensive evaluation are essential to ensure appropriate treatment and to minimize potential complications.

Living with Discitis

Living with discitis poses challenges. You need ongoing symptom management and treatment adherence to maintain quality of life. Long-term benefits of treatment bring pain relief, better mobility, and prevention of complications like spinal deformity or neurological deficits.

Long-Term Outlook for Discitis Patients

The long-term view for discitis patients looks good with fast care. Most cases heal once you treat the root cause. Germ discitis often heals well with strong drugs. Viral cases may clear on their own. If an immune flaw starts it, you must treat that disease for your health.

Lasting back pain or movement limits are rare, most often with late care. Some folks may face short-term drug side effects. A doctor can watch and help with these. You should track signs and tell your doctor about worse pain or new signs. Extra tests or care may help.

Steady follow-ups and sticking with your plan raise results. They cut return risk and guard spine health and day-to-day life over time.

Why Choose Southwest Scoliosis and Spine Institute

From the first time you walk into our offices in either Dallas, Plano, or Frisco, Texas, you will feel at ease. Our fellowship-trained, board-certified expert orthopedic scoliosis surgeons, Richard Hostin, MD, Devesh Ramnath, MD, and Ishaq Syed, MD, will listen and understand your problem and perform a detailed exam. Individuals seeking treatment for discitis may benefit from choosing the Southwest Scoliosis and Spine Institute. The institute offers comprehensive spine care, including advanced diagnostic techniques, personalized treatment plans, and minimally invasive spine surgery options. Finally, the team’s expertise and commitment to patient-centered care make them a trusted choice for individuals seeking relief from discitis and other spine-related conditions.

Citation: Medscape – Discitis

The medical content on this page has been carefully reviewed and approved for accuracy by the Southwest Scoliosis and Spine Institute’s qualified healthcare professionals, including our board-certified physicians and Physician Assistants. Our team ensures that all information reflects the latest evidence-based practices and meets rigorous standards of medical accuracy, with oversight from our expert spine doctors to guarantee reliability for our patients.