Infection of the vertebrae

Aetiology

• Mostly haematogenous, most commonly staph. aureus
• May be associated with abscess - epidural, psoas
• As the vertebral end plates weaken, vertebrae may collapse leading to kyphosis or vertebra plana (flat vertebra) and disc space may reduce

Risk factors

• PWID
• Poorly controlled diabetes
• IV site infections
• GU infections
• SSTI
• Post operative
• Primary bacteraemia in the elderly

Clinical features

Symptoms

• Patients present with insidious onset of back pain (most commonly lumbar) which is constant and unremitting

Signs

• Paraspinal muscle spasm
• Spinal tenderness
• May have fever and/or systemic upset