Infection of the spine

*1. What are risk factors for vertebral body osteomyelitis and discitis?
*2. What are the most common infectious agents?
3. What diagnostic studies are used for spine infection?
4. What is the treatment of spine infection?

Answers:
1. Age, diabetes, immunodeficiency, penetrating trauma, GU procedures, invasive spinal procedures, intravenous drug abuse (incr cervical risk), TB (thoracolumbar jxn).
2. Staph aureus (most common), pseudomonas (IV drugs), TB (Pott's disease).
3. By 2 wks, X-ray shows disc space narrowing and blurred endplates. MRI most sensitive: T1 hypointensity, T2 hyperintensity, gadolineum enhancing. Leukocytosis, increased ESR, CRP, positive bone bx.
4. Conservative care icludes spinal immobilization and antibiotics with early ambulation. Surgical care includes decompression or fusion.