Vertebral Osteomyelitis

Aka: Vertebral Osteomyelitis, Spinal Osteomyelitis

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II. Epidemiology

  1. Most common type of hematogenous Osteomyelitis

III. Pathophysiology

  1. Polymicrobial in 5-10% of patients

IV. Risk Factors

  1. Extraspinal infection site
  2. Urinary tract instrumentation
  3. Indwelling vascular catheter
  4. Hemodialysis
  5. Intravenous Drug Abuse
  6. Cancer
  7. Diabetes Mellitus

V. Causes

  1. Common causes
    1. Hematogenous spread
    2. Surgery
  2. Other causes
    1. Trauma
    2. Adjacent infection spread
    3. Spine Surgery complication

VI. Symptoms

  1. Severe pain in back or neck
  2. Overlying Muscle tenderness
  3. Limited spine range of motion
  4. Fever may be present

VII. Imaging

  1. MRI Spine

VIII. Management

  1. Antibiotic course for 6 weeks
  2. See Spinal Infection
  3. See Acute Osteomyelitis Management

IX. References

  1. Bury (2021) Am Fam Physician 104(4): 395-402 [PubMed]

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