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If a vertebra is inflamed, mostly due to a bacterial infection, this is called spondylitis. In many cases, the inflammation also spreads to adjacent intervertebral discs (spondylodiscitis). The first and more unspecific signs are pain in the spine. More detailed examinations do not always provide sufficient evidence of the rare, serious illness. This often delays the diagnosis and the necessary prompt treatment.
Spondylitis describes the inflammation of one or more vertebral bodies. If such an inflammation spreads to the adjacent intervertebral discs, one speaks strictly of a spondylodiscitis. This is a relatively common combination of the isolated clinical pictures of vertebral inflammation and disc inflammation (discitis).
In general, these diseases of the spine are very rare.
The unspecific spondylitis and special forms
Different infectious and non-infectious forms are distinguished according to the causes. The most common variant is unspecific spondylitis, which arises due to an undetermined hematogenic infection (usually caused by bacteria).
A specific spondylitis includes inflammation of the vertebrae, which can be attributed to certain infectious diseases. This is the case, for example, in the context of tuberculosis (spondylitis tuberculosa) or brucellosis (spondylitis brucellosa).
In addition, ankylosing spondylitis, also known as ankylosing spondylitis, is considered a non-infectious special form. This is one of the inflammatory rheumatic diseases in which the immune system fights the body's own structures (autoimmune disease). There is also psoriatic spondylitis, psoriasis with involvement of the spine, which is often initially mistaken for Bechterew's disease.
With inflammation of the vertebral body, back pain primarily occurs in the affected spine segment. In particular on the cervical and lumbar spine, the pain can also radiate into the extremities and be perceived, for example, as sciatic pain. Due to the pain symptoms, gentle and bad postures can occur, which in addition lead to muscle tension and restrictions on mobility.
The complaints are felt individually and, depending on the severity, to different degrees. In some people with an infectious form of inflammation, in addition to the symptoms on the back, there are also general signs of infection such as fever, body aches and fatigue.
The most common cause of spondylitis is a bacterial infection. The pathogens can often not be determined exactly, but if they do, most of them are staphyolococci (Staphylococcus aureus) as the cause of the disease. Other bacteria, fungi, viruses or even parasites are less likely to be the trigger.
It can happen that urinary tract infections or inflammation of the tooth roots spread via the bloodstream (hematogenous) to the vertebrae (and intervertebral discs) and the disease manifests itself there. In the same way, infections can also occur with open bone fractures or surgical interventions, which can affect large areas of the organism.
For a diagnosis, the detailed patient survey and clinical examination provide first indications and, in particular, enable a closer assessment of the local pain sensation. Usually orthopedic expertise is brought in at this point.
In the early stages, it is difficult to recognize the disease if there are no typical signs from further examinations. Then the back pain or lower back pain can also be misinterpreted.
Further analyzes are laboratory analyzes of a blood sample. In the case of inflammation, results often show a strong increase in white blood cells (leukocytosis) as well as increased values for the C-reactive protein (CRP) and the blood sedimentation rate. Imaging methods such as X-rays and magnetic resonance imaging are also essential. The latter procedure also depicts inflammatory processes in the bones and soft tissues.
If spondylitis is suspected, bone scintigraphy or positron emission tomography (PET) is also carried out in some cases to examine the bone metabolism.
The diagnosis of vertebral inflammation should always be taken very seriously and those affected should receive therapy immediately. If left untreated, the disease can spread to other areas and then lead to life-threatening complications.
The individual treatment regimen depends on the causes and the severity of the disease. If bacteria are the cause of the disease, intensive antibiotic therapy must be carried out. In more serious cases, surgical measures are also used to remove tissue that has already been destroyed. A longer treatment period and rehabilitation can usually be expected, with regular follow-up checks being necessary.
In order to maintain the functionality (stability and mobility) of the spine, targeted movement therapy and, if necessary, the use of orthoses are recommended after the first treatment measures.
Various pain relievers and anti-inflammatory drugs are used for symptomatic treatment.
In the case of such dangerous and serious inflammations or bacterial infections, conventional medical treatment is primarily important.
In a second step, natural healing methods and complementary therapeutic approaches can also support the healing process.
Proven medicinal plants with anti-inflammatory and antibacterial effects include angelica and arnica. In addition to some other (sometimes controversial) therapy methods, a healthy lifestyle is of great importance for a quick recovery. (tf, cs)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. rer. nat. Corinna Schultheis
- Herold, Gerd: Internal Medicine 2019, self-published, 2018
- German Society for Rheumatology (DGRh): S3 guideline for axial spondyloarthritis including ankylosing spondylitis and early forms, as of November 2013, detailed view of guidelines
- Merck & Co., Inc .: Ankylosing spondylitis (accessed: June 26, 2019), msdmanuals.com
- Poddubnyy, Denis / van Tubergen, Astrid / Landewé, Robert / u .: Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis, BMJ Journals, Volume 74, Issue 8, ard.bmj.com
- Sobottke, Rolf / Seifert, Harald / Fätkenheuer, Gerd: Current diagnosis and therapy of spondylodiscitis, Dtsch Arztebl 2008, aerzteblatt.de
ICD codes for this disease: M45, M48, M49ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.