Discitis - Diskitis

Diskitis is the infection or inflammation of the disk between two vertebrae.

What is going on in the body?

The spine consists of bony structures called vertebrae stacked one on top of another. Vertebrae are separated by disks, which are plate-like bodies made up of cartilage. These disks act as shock-absorbing cushions. In diskitis, the disk becomes infected or inflamed, later causing destruction of the adjoining vertebral bone. Diskitis usually affects children ranging from toddlers to adolescents. The most common part of the spine involved is the lower back.

What are the causes and risks of the disease?

Diskitis is caused when an infection in another part of the body, particularly the pelvic area, spreads through the blood stream to the spine. Bacteria are found in less than half of cases. Other cases are thought to be viral or inflammatory. In rare cases, such as in tuberculosis, infection may spread from bone to disk, which is the reverse order of the spread in diskitis.

What are the signs and symptoms of the disease?

The main symptom is pain. The toddler may refuse to walk or may lean forward when walking, sometimes with the hands on the thighs to support the back. Getting up from the floor may also be hard.

Signs include a temperature ranging from normal to low-grade fever, depending on the type of infection. It may also be hard for the child to raise a leg straight up while lying on his or her back.

How is the disease diagnosed?

A doctor may suspect diskitis based on the symptoms and signs above, but diagnosis is often not easy. Blood tests may show signs of infection, but are not enough to make the diagnosis. An x-ray can show the narrowing of disk space and abnormalities in the vertebrae, but not until 2 to 3 weeks after the onset of the disease. Bone scans and special x-rays such as an MRI often help reveal the spread of infection in a given area.

What can be done to prevent the disease?

The best prevention is prompt, correct treatment of infections in other parts of the body.

What are the long-term effects of the disease?

If the infection progresses to involve the vertebrae significantly, the vertebrae of the spine may fuse, which means to grow together. If this occurs in a young child, the spine may begin to tilt forward as it grows, a condition known as kyphosis.

What are the risks to others?

There are no risks to others, as diskitis is not catching.

What are the treatments for the disease?

Treatment varies depending on what the cause may be. If the cause is bacterial, a combined therapy of intravenous and oral antibiotics may be given for a total of 4 to 6 weeks. For other causes, therapy may consist of rest and a body brace or cast. Surgery is rarely needed to clean out the infection.

What are the side effects of the treatments?

In the case of prolonged antibiotic use, side effects, such as diarrhea or allergic reaction to the medicine may occur.

What happens after treatment for the disease?

Potential complications include kyphosis or chronic inflammation of the spine.

How is the disease monitored?

Pain levels and temperature should be monitored. The doctor will check blood tests and x-rays periodically. Any new or worsening symptoms should always be reported to the doctor.

Author:John A.K. Davies, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:09/02/02
Reviewer:Melinda Murray Ratini, DO
Date Reviewed:09/01/02