Vertebral osteomyelitis and discitis

Sexton, Daniel J., and McDonald, Malcolm (2012) Vertebral osteomyelitis and discitis. In: Sexton, Daniel J., and Baron, Elinor L, (eds.) UpToDate. Wolters Kluwer Health, 1-12.

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[extract] INTRODUCTION — Vertebral osteomyelitis was recognized as a distinct clinical entity by Hippocrates and Galen. Prior to the discovery of antibiotics, vertebral osteomyelitis was fatal in approximately 25 percent of affected patients [1]. Mortality is now rare, but morbidity is common; in addition, delays in diagnosis can lead to disabling complications.

The terms vertebral osteomyelitis and discitis are often used interchangeably by clinicians. As the disc space has no direct blood supply in adults, this space is secondarily involved when a hematogenous infection spreads to bone and subsequently spreads to the adjacent intervertebral disc space. However, infection can also spread from the disc space to adjacent bone when infection arises after surgery or following disc space injections. (See 'Pathogenesis' below.)

For the purposes of this discussion, the terms vertebral osteomyelitis and discitis will be used interchangeably as the diagnosis and management of the two entities is similar in most patients.

Pyogenic vertebral osteomyelitis will be reviewed here. The closely related topics of spinal epidural abscess and tuberculous spinal infections are discussed separately. (See "Epidural abscess" and "Skeletal tuberculosis".)

Item ID: 22248
Item Type: Book Chapter (Teaching Material)
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Topic 7663 Version 5.0

Date Deposited: 18 Dec 2012 03:19
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110314 Orthopaedics @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 100%
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