What is Discitis or Diskitis ?
A human spine is build up of many vertebrae that stack on one another. The cartilage forms a disc or plate like structure in between these vertebrae which also acts like a shock absorber by cushioning and separating these vertebrae.
Discitis is a condition which is characterized by inflammation of vertebral disc space present in the spine. Discitis occurs very rarely. Discitis is a condition which may occur at any age. Discitis is more common in children below nine years if age. Discitis may also occur after a spinal surgery as a complication, but that is a very rare phenomenon.
Discitis is a disease which occurs when intervertebral discs become inflamed. This usually occurs as a result of an infection in any of the parts of body, particularly the pelvic region and extends to the spine during the process of blood flow.(1) Further this infection may also get transferred to vertebral bones through the discs.
Discitis is a disease which usually results in swelling or inflammation at the space present between the spinal vertebrae. The reason behind the occurrence of discitis may be an autoimmune condition or an infection.
Spreading of infection to a considerable extent may lead to chronic inflammation of the spine. In few of the cases, the infection may also result in fusion of the vertebrae with each other. When this occurs in a young child, the vertebrae develop together in a fused way forcing the spine to tilt forward during the growth process. This condition is called as kyphosis.
Types of Discitis (Diskitis)
- Septic Discitis: Septic discitis is a very rare type of discitis. Septic discitis is a condition in which bacteria directly enters the space present between the vertebral discs. The classification for septic discitis usually depends upon the sources such as postoperative, hematogenous or contagious. The very common bacteria, which leads to discitis is Staphylococcus aureus. However, other microorganisms such as Escherichia coli and Staphylococcus epidermidis may also be responsible.
- Infectious Discitis: Infectious discitis involves symptoms such as sweat, loss of appetite, fever and chills resulting from invasion of the microorganisms between the disc spaces located in the spinal column.(2)
- Lumbar Discitis: Lumbar discitis is a condition which occurs due to problems in the lumbar region present in the spinal column. Being a self limiting disease, lumbar discitis does not spread and infect the other discs of the spinal column.
- Osteomyelitis Discitis: Osteomyelitis discitis is inflammation of the bones. Osteomyelitis discitis may either be acute or chronic. They may either affect the bones of the spinal column or may affect the other bones present in the vertebral region. The cause for this again is mostly microorganisms.
Epidemiology of Discitis (Diskitis)
Discitis is a very rarely caused disease. The frequency rate of the disease in United States ranges between 1 in 100,000 to 1 in 250,000. About 11% of the discitis cases are reported in few of the regions of Africa. Males are more prone to discitis than females with the average ratio ranging from 2:1 to a high of 5:1.
Causes and Risk Factors of Discitis (Diskitis)
- Discitis is considered to be caused by an infectious agent like Staphylococcus aureus or other microorganisms.
- Deforming dorsopathy- Condition results in abnormal curvature or deformity of vertebral column or dorsal column.
- Spondylopathies- Inflammatory disorder of vertebral column.
- Lordosis– Anterior exaggerated curvature of vertebral column results in additional pressure over lumbar disc.
- Kyphosis- Exaggerated curvature of thoracic vertebral column results in hunch back.
- Intervertebral disc space.
Signs and Symptoms of Discitis (Diskitis)
- Severe pain in lower back may be experienced.
- Children may feel difficulty while walking and sometimes may even refuse to walk due to severe pain.
- Patients may also support the back during walking.
- Frequent leaning back of the patients may also be noticed.
- Difficulty while getting up from the floor.
- Mild fever depending upon the degree and kind of infection.
- Difficulty while raising the leg in the upward direction when lying down on the back.
- Loss of appetite.
- Sudden chills and sweats.
- Feeling tired.
- Pain may also spread from the back to the other parts of the body like abdomen, hip, leg or groin.
Treatment for Discitis (Diskitis)
- The treatment for discitis usually depends up on the type of infection. The treatment may involve medication and surgery. However, the oral and intravenous antibiotic course for one month may also be prescribed in case of infection caused due to bacteria.
- Acupuncture may be an option for treating pain. Period or rest is very essential and movement should be attempted only when the pain subsides. A cast or a brace may be used for supporting the spine and to avoid pressure.
- Regular or continuous consumption of antibiotics leads to allergies or diarrhea. Checking the temperature and pain levels is also very important. X-rays and scans must be performed periodically.
- Immediate medical attention should be sought if the pain worsens or any new symptoms arise. Prompt treatment should be sought for any infection that may be noticed in any part of the body.
- Surgery is performed in very severe cases. Surgery helps in cleaning out severe kinds of infections. Metallic insertions or fusion plugs may be helpful in performing movements.
Investigations for Discitis (Diskitis)
Discitis is really difficult to diagnose as the blood tests taken for infections are not enough to evaluate the disease. The problems related to constriction of disc space and vertebral abnormality is visible on x-ray only after 2 to 3 weeks of occurrence of the disease. MRI and bone scans help in recognizing the overall status of infection. Complete blood counts to check for elevated white blood cells.