Can a spine be transmitted between people
Spine Infections: Inflammation of the vertebral bodies (spondylitis) and intervertebral discs (spondylodiscitis), usually caused by bacteria. The pathogens either get from a source of infection in the body via the blood into the spine (e.g. in the case of a tuberculosis infection), or they are transmitted from the outside through an open injury or through medical intervention (e.g. in injections near the spine or operations ). Infections of the spine are noticeable through local pain, relieving posture and signs of inflammation such as night sweats and fever. Depending on the extent of the infection, the therapy ranges from antibiotic treatment in hospital for several weeks to surgery. With timely treatment, the prognosis is good, especially in children.
- Local, mostly dull and boring pain in the back, including at night
- Sensitivity to touch and pressure over the affected vertebra
- Pain when bending forward, stiff posture (relieving posture)
- Night sweats, fatigue and fever
- Rare: paralysis and sensory disturbances when the spinal cord is also affected
- In the late phase, formation of an acute-angled hump (Gibbus) through destruction of the affected vertebral body.
When to the doctor
In the next few days at
- nocturnal back pain and restricted mobility
- Formation of abnormal sensations or sensory disturbances.
The same day
- when paralysis occurs.
Causes and Risk Factors
Spinal infections are mainly caused by bacteria, less often by fungi or parasites. The pathogens enter the spine in two ways:
- From the inside via the bloodstream from a source of infection that can be anywhere in the body. In the industrialized nations this is mostly an initially undetected blood poisoning, e.g. B. due to gastrointestinal infections or a cystitis. In developing countries, tuberculosis is the main cause of spinal infections.
- From the outside through an open injury or through medical intervention (injections or operations) in the spine.
People whose immune system is impaired are particularly at risk for spinal infections, e.g. B. due to diabetes, alcohol addiction, tumor diseases, HIV infection, malnutrition or long-term treatment with cortisone preparations or cytostatics.
The inflammation usually begins in the vertebral bodies and then continues to the intervertebral disc, often spreading to neighboring soft tissue. The inflammatory changes lead to painful rest at night. Patients often show general signs of infection such as fever, chills, and a general feeling of illness. In the long term, there can be significant weight loss. Without treatment, the destruction of the vertebrae leads to the formation of kinks in the spine, for example a hump (gibbus) arises through which the patient stands and walks bent forward. If the inflammation spreads to nerve structures, there is a risk of sensory disorders and paralysis. If the disease is very advanced, the infection occasionally spreads to the chest or abdomen.
If the symptoms indicate an infection of the spine, the doctor first looks for signs of inflammation in the blood and, in the case of a fever, also for bacteria. Magnetic resonance imaging and bone scintigraphy make the inflammatory and destructive processes in the bones and soft tissues visible. Tissue removal (biopsy) is rarely required to confirm the diagnosis.
Differential diagnoses. Similar complaints are caused by tumors in the spine or rheumatic diseases such as B. causes ankylosing spondylitis. In the case of a spinal infection, it is always important to rule out tuberculosis.
The cornerstones of treatment are immobilization of the spine and antibiotic therapy (in the rare cases in which the infection was triggered by other pathogens such as fungi or parasites, instead with the appropriate active ingredients such as antifungal agents).
Immobilization (Immobilization). So that the affected vertebral bodies do not collapse due to the inflammatory changes and the inflammation can heal, the spine must be immobilized. This is done with special orthoses or plaster shells. Depending on the extent of the bone changes, the patient also has to stay in bed for several weeks.
Pain management. The doctor prescribes paracetamol (e.g. ben-u-ron®) or ibuprofen (e.g. Nurofen®) against the often severe pain and to contain the inflammation.
Antibiotics. To treat a bacterial infection, the patient receives an infusion treatment with high-dose antibiotics (or antifungal agents in the case of a fungal infection) for 2 to 4 weeks. First, the doctor prescribes a broad-acting antibiotic that works against the most common pathogens that cause spinal infections. As soon as the responsible germ has been detected in the blood or in the tissue sample, the antibiotic therapy is adapted to this pathogen. Subsequent treatment with tablets is necessary until the inflammation levels in the blood return to normal - this usually takes several months. The infection usually heals without permanent damage.
Operative treatment. If antibiotic therapy does not have an adequate effect, abscesses develop in neighboring soft tissues, or the spine loses its stability, the infection must be treated surgically. The surgeon usually exposes the affected vertebral body from the front (the patient lies on his back), removes the diseased tissue, flushes out the pus and, if necessary, stiffens the destroyed spinal column sections (spondylodesis).
Spinal infections take a long time to heal; it usually takes months for the pathogens to disappear from the bones and intervertebral discs and for the inflammation to be contained. In rare cases, the inflammatory process can flare up again after years. The prognosis in children is generally favorable, and spinal infections usually heal without consequences.
Your pharmacy recommends
What you can do yourself
Make sure you take the prescribed antibiotic therapy regularly as prescribed - even if the symptoms have already disappeared. Spinal infections are persistent and take a long time to actually contain the inflammation and eliminate the pathogens.
In order to heal, the body absolutely needs rest. Keep bed rest if directed.
A final healing can be said after a few months to a year at the earliest. Make the necessary follow-up checks so that your doctor can keep an eye on the progress of your illness and recognize and treat any complications in good time.
AuthorsDr. med. Siegfried Locher in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 17:31
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