+ Back pain is often the most common presenting symptoms of vertebral osteomyelitis. However, in its early stages, the clinical assessment is often non-focal and non-specific.
+ Fever may be present in only one-half of patients. If patients present with fever and back pain, a CBC may be performed, although many patients have a normal neutrophil and no leukocytosis. Elevated erythrocyte sedimentation rate and C-reactive protein serum tests have a high sensitivty and are useful in the workup of vertebral osteomyelitis. Both aerobic and anaerobic blood cultures should also be drawn.
+ MRI with contrast is the optimal imaging modality as x-rays are insensitive to vertebral osteomyelitis. If an MRI cannot be performed, SPECT is the next best option.
+ Antibiotic therapy is the primary treatment. Surgery is indicated if there is neurologic compromise, spine instability, etc.
+ Complications from vertebral osteomyelitis include chronic pain, disability, vertebral fracture, etc.
+ Approximately 10-30% of acute osteomyelitis cases become chronic, in which patients may experience frequent relapses. The approach to chronic osteomyelitis is directed towards infection cessation, pain management, and functional maintenance.
+ Fever may be present in only one-half of patients. If patients present with fever and back pain, a CBC may be performed, although many patients have a normal neutrophil and no leukocytosis. Elevated erythrocyte sedimentation rate and C-reactive protein serum tests have a high sensitivty and are useful in the workup of vertebral osteomyelitis. Both aerobic and anaerobic blood cultures should also be drawn.
+ MRI with contrast is the optimal imaging modality as x-rays are insensitive to vertebral osteomyelitis. If an MRI cannot be performed, SPECT is the next best option.
+ Antibiotic therapy is the primary treatment. Surgery is indicated if there is neurologic compromise, spine instability, etc.
+ Complications from vertebral osteomyelitis include chronic pain, disability, vertebral fracture, etc.
+ Approximately 10-30% of acute osteomyelitis cases become chronic, in which patients may experience frequent relapses. The approach to chronic osteomyelitis is directed towards infection cessation, pain management, and functional maintenance.
- Graeber A, Cecava ND. Vertebral Osteomyelitis. [Updated 2019 Jun 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532256/
- Walter G, Kemmerer M, Kappler C, Hoffmann R. Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int. 2012;109(14):257–264. doi:10.3238/arztebl.2012.0257
- Walter G, Kemmerer M, Kappler C, Hoffmann R. Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int. 2012;109(14):257–264. doi:10.3238/arztebl.2012.0257
