Spinal Discitis and Epidural Abscess

Spinal infections (SI) affect disc, vertebral, and adjacent tissues. Diagnosis delayed due to nonspecific symptoms, must suspect SI early.

Spinal infections (SIs) affect intervertebral discs, vertebral bodies, and surrounding tissues, commonly in the lumbar region. Symptoms are non-specific, causing diagnostic delays. Clinicians must suspect SI early. This Element presents two real cases, reviews core knowledge, highlights diagnostic challenges, and outlines treatment options.Spinal infections (SIs) are rare conditions affecting the intervertebral disc, vertebral body and/or adjacent spinal tissues. The lumbar region is most commonly involved, followed by the thoracic and cervical regions. Patients present with varied, non-specific clinical features leading to diagnostic and treatment delays. Clinicians need to have a low threshold to suspect SI. In this Element, two real-life cases of patients with SIs will be presented first. Core knowledge will be reviewed next, followed by diagnostic pitfalls and clinical pearls. Finally, the 'typical' clinical workflow for a patient with SI will be presented and the various treatment options will be explored.