Definition Discitis is the infection or inflammation of the disc between 2 vertebrae.
What is going on in the body? The spine consists of bony structures called vertebrae stacked one on top of another. Vertebrae are separated by discs, or plate-like bodies made up of cartilage, that act as shock-absorbing cushions. In discitis, the disc becomes infected or inflamed, later causing destruction of the adjoining vertebral bone. Discitis usually affects children ranging from toddlers to adolescents. It may be seen in adults as a complication of spinal surgery. The lower back area (lumbar spine) is the part of the spine most often involved.
What are the signs and symptoms of the disease? The main symptom is pain. The toddler may refuse to walk or may lean forward when walking, sometimes with the hands on the thighs to support the back. Getting up from the floor may also be difficult.
Signs include a temperature ranging from normal to low-grade fever, depending on the type of infection. Straight leg raising may be limited.
What are the causes and risks of the disease? Discitis is caused when an infection in another part of the body, particularly the pelvic area, spreads through the blood stream to the spine. Bacteria are found in less than 50% of cases. Other cases are thought to be viral or inflammatory. In rare cases, such as in tuberculosis, infection may spread from bone to disc, the reverse order of the spread in discitis.
What can be done to prevent the disease? The best prevention is the prompt, appropriate treatment of infections in other parts of the body.
How is the disease diagnosed? Discitis is suspected based on the symptoms and signs above, but diagnosis is often not easy. Blood tests may show signs of infection, but are not enough to make the diagnosis. An x-ray can show the narrowing of disc space and abnormalities in the vertebrae, but not for about 2 to 3 weeks after the onset of the disease. Bone scans and special x-rays such as an MRI are often helpful, revealing the spread of infection in a given area.
What are the long-term effects of the disease? If the infection progresses to involve the vertebrae significantly, the vertebrae of the spine may fuse, or grow together. If this occurs in a young child, the spine may begin to tilt forward as it grows, a condition known as kyphosis.
What are the risks to others? There are no risks to others, as discitis is not contagious.
What are the treatments for the disease? Treatment varies depending on what the cause may be. If the cause is bacterial, a combined therapy of intravenous and oral antibiotics may be given for a total of 4 to 6 weeks. For other causes, therapy may consist of rest and a body brace or cast. Rarely is surgery need to clean out the infection.
What are the side effects of the treatments? In the case of prolonged antibiotic use, side effects, such as diarrhoea or allergic reaction to the medication may occur.
What happens after treatment for the disease? Potential complications include kyphosis or chronic inflammation of the spine.
How is the disease monitored? Pain levels and temperature should be monitored. The doctor will check blood tests and x-rays periodically.
Author: Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 21/10/2004 Contributors Potential conflict of interest information for reviewers available on request
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