A spinal abscess starts with an infection near the spine that develops into a collection of pus — infected fluid — that causes pressure on the spinal cord and nearby nerves. It is a medical emergency.
When the infection starts, the patient often notices pain in the neck or back near the place of the actual infection, but sometimes the pain can appear to be in an arm or leg because the infection irritates nerve roots feeding those limbs. As the pressure builds from the pocket of pus near the spinal cord, the patient gets numb and tingling sensations, and then loss of ability to use the limbs below the level of infection. This can move slowly or quite rapidly depending on the patient’s immune system and how virulent the bug is.Emergency treatment is necessary to save the spinal cord from being literally choked off, losing its blood supply and leading to permanent injury and paralysis.
Who is at risk for spinal abscesses?
- Patients who have had spinal surgery, especially in the recent past, and especially if hardware was placed into the spine. The hardware acts as a “seeding” site for the bacteria.
- Patients with another site of infection – infected gums, boils, skin abscesses, bladder infection, endocarditis – can have migration of bacteria to the spine.
- High-risk patients are anyone with reduced immune systems, such as HIV infections, patients taking long-term steroids, diabetics.
- IV drug abusers who inject bacteria into their veins with dirty needles.
Doctors examining patients need to pay attention to these risk factors and look for tenderness over the spine, and increased pain especially when laying flat. Usually an MRI is done for definitive diagnosis.
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