ABSTRACT
Spinal infections can be pyogenic, granulomatous or parasitic. Pyogenic vertebral osteomyelitis is the most commonly encountered form of vertebral infection whereas tuberculosis is more common in the developing countries. Infection develops from haematogenous spread of bacteria, by direct inoculation, by contiguous spread from adjacent structures or from iatrogenic causes. The primary focus of infection in the spine can be in the vertebral body, the intervertebral disc, the epidural space or in the posterior elements. Early diagnosis and management is important, as good results can be obtained even with conservative treatment in the initial stages. But left untreated, these infections can lead to permanent neurological deficits, significant spinal deformity or even death. Management principles in early cases include identification of the organism, appropriate antimicrobial chemotherapy and supportive treatment. Surgical treatment is indicated in patients with extensive vertebral destruction, abscess formation, neurological deficits, deformity and severe pain due to instability. Prognosis depends on the extent of the disease, the type of organism, the severity of neurological and vertebral damage and the general condition of the patient.
