Osteomyelitis of the spine does not immediately give its symptoms, but if they are detected, you need to immediately begin the diagnosis and further treatment. Diagnosing this pathology is time-consuming and lengthy (it can take from 2 weeks to several months).
The complex of diagnostic studies includes:
- contrast MRI (more informative and accurate compared to x-ray);
- CT scan;
- bacterial culture of blood and urine (allows you to determine the possible causative agents of osteomyelitis);
- bone tissue biopsy to accurately determine the pathogen (may be open or closed);
- determination of the presence of inflammation markers (erythrocyte sedimentation rate, histamine level and others).
Inflammation of the bone marrow of the spine also reflects a violation of the normal content of various cells in the blood (platelets, red blood cells and some white blood cells), since this part of the vertebrae is responsible for the “reproduction” of these structures. But noticeable changes appear a few months after the onset of pathology.
Which doctor treats osteomyelitis of the spine?
When the patient has confirmed spinal osteomyelitis with the help of diagnostics, the treatment should be complex, several doctors prescribe him: an orthopedist, immunologist and other specialists. If it is necessary to remove the affected and dead bone tissue, then resort to the help of a surgeon.
Treatment of osteomyelitis is divided into conservative or non-invasive and surgical. In the first case, the following is used for therapy:
- a course of antibacterial drugs, they are often administered intravenously (Amoxiclav, Augmentin, Bacteriophage, Ofloxacin, Zinacef, Linkomycin);
- immunomodulating and immunostimulating drugs to increase the protective function of the body (Echinacea, Maksidin, Immunity, Flaraxin);
- hormonal or non-steroidal anti-inflammatory drugs (Naproxen, Ibuprofen, Aceclofenac, Celecoxib, Ketorolac);
- a rigid corset for fixing the spine (it is necessary to wear it until the patient’s state of health becomes stable, and the x-ray does not show the positive dynamics of therapy).
Surgical treatment of osteomyelitis is necessary in cases where the foci of infection are large, a large amount of pus accumulates in them, and an abscess begins. The latter is dangerous in that it can provoke compression of the nerve endings, increases the risk of blood poisoning or toxic substances entering the spinal cord. Also, surgery is required in case of significant destruction of bone tissue, which must be removed and reconstructed.
Predicting the occurrence of osteomyelitis is quite difficult, therefore, the rules of prevention are general:
- avoid back injury, and when injuries are received, start therapy in a timely manner;
- start timely treatment of infectious diseases of other systems and organs;
- in the presence of problems with the body’s immune system, it is necessary to strengthen it with the help of drugs, diet, healthy lifestyle;
- give up intravenous drug use.
Osteomyelitis of the tissues of the spine is dangerous because its symptoms do not appear immediately, the disease develops, provoking the accumulation of pus in the vertebrae and the death of their cells. For the diagnosis, various instrumental and laboratory research methods are used, confirmation of the diagnosis and determination of the pathogen can take from several weeks to months. Therapy of osteomyelitis depends on the form and neglect of the pathology, it can be conservative or surgical.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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