Septic Spondylodiscitis

By Medical
Posted 2014-02-13

Excel Medical Group

2014-02-13

Real Case

In June 2013, 67-year-old Mr. Feng came to see a doctor due to long-term cervical and low back pain and numbness of hands and feet. X-ray and MRI showed that the cervical spine and lumbar spine had strain degeneration, and the fifth and sixth cervical vertebrae had spinal stenosis. The fifth intervertebral disc of the lumbar spine was severely herniated and pressed against the first nerve root of the sacrum, causing foot numbness.

Because the patient does not want to undergo surgery, it is hoped that conservative treatment can further relieve the condition and reduce the rate of deterioration. After several months of Cox ® Decompression Manipulation, the neck and back pain and numbness of hands and feet have been greatly improved (#), and it is planned to reduce the Decompression Manipulation once a week from 12 sessions.

Suddenly on the afternoon of December 10, I received a call from Mr. Feng said his back pain suddenly worsened, his low back and feet were unable to move, he was extremely painful, and he also had a slight fever. Later, he also experienced difficulty urinating and leg weakness and numbness, which seemed to have appeared symptoms of acute cauda equina syndrome.

I immediately referred the patient to a spinal neurosurgeon, and was admitted to the hospital for examination and treatment. After a long-term examination, it was found that Mr. Feng’s blood was infected with Staphylococcus aureus, and the lungs and lumbar dura mater were affected. MRI showed the lumbar spine There is an abscess in the dura mater, which is pressing on the spinal cord. Urgent decompression operation and spinal abscess should be performed immediately.
After the operation, the patient’s low back pain improved (#), the fever subsided, and the doctor continued to fight the bacteria with intravenous antibiotics. The frightening thing is that the stubborn bacteria caused Mr. Feng had to contract a lumbar dural abscess again two days later, and Mr. Feng had to undergo another lumbar pus surgery. Fortunately, the patient’s condition has stabilized after the operation and is now recuperating at home.

The structure of the spinal canal

Cause of Septic Spondylodiscitis

The route of infection is usually from the blood to the vertebral body after being infected by the explants, and then directly infect the intervertebral disc through the lamina, causing spine and intervertebral discitis. The infection can extend to the dura mater of the spine and cause an abscess. This dural abscess can compress the spinal cord and cause neuralgia such as low back pain, foot paralysis, and even acute cauda equina syndrome.

Symptoms

1. Fever

2. Shivers

3. Incontinence

4. Low Back Severe Pain

5. Numbness on the lower body

6. Pain extends to the feet, back and hands

Diagnose

Through the patient’s clinical symptoms

Blood analysis

Imaging examinations such as CT Scan and MRI

Extract the abscess for laboratory tests to confirm the infection

Treatment

If the patient has symptoms of nerve compression, decompression surgery and abscess removal must be used, as well as antibiotics to combat the explants.

Conclusion

If the patient has symptoms of nerve compression, decompression surgery and abscess removal must be used, as well as antibiotics to combat the explants.

Adults with persistent low back pain and other symptoms must find the cause and treat it in time. Delayed diagnosis and treatment can cause permanent low back pain or nerve defects (such as incontinence or lower body palsy or numbness of hands and feet).

(#) This is an individual case, and the actual results vary from person to person.

Source: Chiropractor Dr. Matty Wong from Excel Medical Group http://www.drbackpain.com.hk/

Author

Dr. Matty F.Y. Wong

Doctor of Chiropractic, NCC, USA