Over the last few years there have been several successful and highly-valued claims where patients have sued their doctors for failing to diagnose infections of the spine or failing to act promptly.
The spine, like any other part of the body, can suffer from infection. Such an infection can be very serious and have hugely significant effects on the patient.
The infection may establish in the softer disc, or it may infect the harder vertebral bones. Once established in the back, the infection can spread up or down the spine in a cascade-effect.
How did I contract the spinal infection in the first place?
Most commonly, the infection arrives in the blood, having spread from other areas of the body.
The veins in the lower spine drain the pelvic area, bladder and prostate. As these areas are naturally susceptible to infection, it is quite common for infections of the spine to follow on.
Similarly, medical procedures can introduce infection to these areas which can then spread to the spine e.g. a cystoscopy that introduces bacteria to the bladder may result in an infection of the spine.
As infection of the spine tends to be a secondary infection, anything that reduces the immune system will increase the risk of this occurring. Risk factors include:
- Recent infections
How do I know whether I have an infection of the spine?
The infection will often present as back pain. It normally sets in steadily over a long period of time.
As the infection progresses, there are some clear warning signs, sometimes referred to as ‘red flags’, to watch out for:
- Fevers and/or chills
- Weight loss
- Stiffness of the neck
- Weakness, numbness or tingling in the arms and/or legs.
- Worsening pain at night
What to be aware of
First and foremost, your doctors should take every precaution to ensure that they do not introduce an infection when carrying out any procedures. They must use sterile equipment and the appropriate aseptic technique.
Secondly, your doctors should be alert to an onset of back pain following any procedure to the pelvis, bladder or prostate.
Thirdly, if an infection has entered your spine, your doctors should be quick to diagnose and appropriately manage it so as to prevent any damage being caused.
How serious is an infection of the spine?
If an infection of the disc is left undiagnosed and/or untreated, the infection will gradually cause the tissue to decay and weaken. Left for long enough, the disc will eventually collapse.
Once a disc has collapsed, the space between the vertebral bones decreases. This pinches the nerves running down the spine and causes pain.
If the infection is in the vertebral bones (osteomyelitis) and is left untreated, the vertebrae will weaken and collapse, much like the disc does. However, as the vertebrae are bigger, decay leads to a more significant shortening of the spinal column and an increase in pressure. In addition, as the curvature of the spine shortens, the internal angles increase and this pinches the nerves further. Too much pressure on the nerves can interfere with the way they work and can cause bodily functions to go wrong.
Alternatively, the infection might spread from the vertebrae into the spinal canal, causing an abscess. Such a growth within the narrow canal will then place extreme pressure on the nerves and can result in paralysis.
An infection of the spine can, therefore, be very serious if left untreated.
How would the infection be treated?
It is most likely that medics will try to initially manage the infection conservatively (i.e. avoid surgery) with medication.
If the infection is too extensive, surgery may be required to remove much of the infected tissue. Surgery will also be necessary if there is evidence that the infection has destabilised the spine or is causing pressure on the spinal cord.
Does the spine recover after an infection?
Assuming the infection has been caught early enough and there is no irreparable damage to the nerves, the spine can largely recover naturally over time.
Collapsed discs can often be managed conservatively with appropriate therapy and management.
Equally, the vertebrae, like any bone in the body, can heal. However, while most bones heal by fusing the damaged area, a damaged vertebrae heals by fusing to other vertebrae .This will not only impact on flexibility and mobility, but can continue to put some pressure on the spinal cord, causing continuous pain.
However, if the infection has been allowed to progress and significant damage has been done, then it may be the case that surgery is required to ensure a good recovery.
If the infection has advanced too far, significantly damaging the nerves in the spine, recovery may not be possible and the paralysis can be permanent.