Acute pediatric spinal infections

Abstract

Acute pyogenic infections of the spine in pediatric age group are reviewed in this chapter. Spinal infections are uncommon in childhood; therefore, the clinical workup should begin with a high level of suspicion. Discitis and vertebral osteomyelitis have distinct epidemiologic, clinical, and radiographic features; however, they are considered to be different manifestations of the same pathological process. Child’s inability to communicate or localize symptoms and nonspecific laboratory findings generally cause a delay in the diagnosis that can be avoided with the early use of spinal imaging. Treatment should include intravenous antibiotics followed by oral intake, and rest and/or immobilization to improve comfort especially in the initial stages. Surgical interventions can occasionally be necessary especially in the setting of neurologic findings. The efficacy and duration of treatment can be followed via the levels of ESR and CRP. Functional deficits generally do not occur regardless of the radiological changes.