chapter  9
12 Pages

Spine Infections

WithMariangela Marras, Luca Saba, Stefano Marcia

Skeletal localization of an infectious process depends on the age of the patient and the type of pathogenic microorganism.1,2 The involvement of the appendicular skeleton is more frequent in childhood and adolescence,

whereas the involvement of the axial skeleton is more frequent in adults.3,4

Magnetic resonance imaging (MRI) is the method of choice in the diagnosis of infection of the spine. The infectious processes can involve all components of the spine. The infectious spondylitis, which constitutes about 5% of pyogenic osteomyelitis, is distinct in two

Mariangela Marras, Luca Saba, and Stefano Marcia

CONTENTS

9.1 Introduction ................................................................................................................................................................. 205 9.2 Types of Spine Infections ........................................................................................................................................... 206 9.3 Etiopathogenesis .......................................................................................................................................................... 206

9.3.1 Pyogenic Forms ............................................................................................................................................. 206 9.3.2 Non-Pyogenic Forms (Granulomatous Forms) ......................................................................................... 206 9.3.3 Pathways of Spread ....................................................................................................................................... 206

9.4 Pyogenic Osteomyelitis .............................................................................................................................................. 206 9.5 Tuberculous Spondylitis ............................................................................................................................................. 207 9.6 Facet Joint Septic Arthritis ......................................................................................................................................... 208 9.7 Dural Abscess: Epidural and Subdural .................................................................................................................... 208 9.8 Paraspinal Abscess ...................................................................................................................................................... 208 9.9 Myelitis ......................................................................................................................................................................... 209

9.9.1 Viral Myelitis .................................................................................................................................................. 209 9.9.2 HIV Myelopathy ............................................................................................................................................ 209

9.10 Myelitis Spinal Cord Abscess .................................................................................................................................... 209 9.11 Spinal Meningitis ........................................................................................................................................................ 209 9.12 Spinal Parasitosis ......................................................................................................................................................... 210

9.12.1 Echinococcosis ............................................................................................................................................... 210 9.12.2 Schistosomiasis .............................................................................................................................................. 210 9.12.3 Cysticercosis ....................................................................................................................................................211

9.13 Inflammatory and Autoimmune Spine Diseases ....................................................................................................211 9.13.1 Multiple Sclerosis ...........................................................................................................................................211 9.13.2 Acute Disseminated Encephalomyelitis Spinal Cord ............................................................................... 212 9.13.3 Idiopathic Acute Transverse Myelitis ......................................................................................................... 213

9.14 Sarcoidosis .................................................................................................................................................................... 213 9.15 Chronic Inflammatory Demyelinating Polyneuropathy ....................................................................................... 213