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Osteomyelitis

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Treatment of Spine Disease in the Elderly

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Abstract

Vertebral osteomyelitis (VO) is typically caused by hematogenous seeding of bacteria but can also be caused through non-hematogenous mechanisms, occurring from direct inoculation during spinal surgery or from contiguous spread from infection in the adjacent soft tissues. Due to its nonspecific clinical presentation, VO may be initially misdiagnosed, leading to diagnostic delay with potential spine deformity as well as neurological complications and deficits. Accurate diagnosis is based on a thorough clinical assessment with a neurological examination, laboratory tests, imaging, cultures, and bone biopsy. VO may be treated conservatively but surgical intervention is typically indicated in the setting of neurologic deficits, spinal instability, progressive deformity, or source control in the setting of failed medical management.

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Author information

Authors and Affiliations

  1. Touro University College of Osteopathic Medicine, Vallejo, CA, USA

    Jacob S. Blitstein

  2. Department of Orthopaedic Surgery, University of California, San Francisco, UCSF/ZSFGH Orthopaedic Trauma Institute, San Francisco, CA, USA

    Ashraf E. El Naga

  3. University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA

    Sanjay S. Dhall

  4. Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA

    Anthony M. DiGiorgio

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  1. Jacob S. Blitstein
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  2. Ashraf E. El Naga
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  3. Sanjay S. Dhall
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  4. Anthony M. DiGiorgio
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Corresponding author

Correspondence to Anthony M. DiGiorgio .

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Editors and Affiliations

  1. Weill Cornell Medical College, New York, NY, USA

    Kai-Ming G. Fu

  2. Departments of Neurosurgery & Rehab Medicine, University of Miami School of Medicine, Miami, FL, USA

    Michael Y. Wang

  3. Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY, USA

    Michael S. Virk

  4. Dept. of Orthopedic Surgery, Leatherman Spine Center, University of Louisville, Louisville, KY, USA

    John R. Dimar II

  5. UCSF Neurosurgery, San Francisco, CA, USA

    Praveen V. Mummaneni

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Blitstein, J.S., El Naga, A.E., Dhall, S.S., DiGiorgio, A.M. (2023). Osteomyelitis. In: Fu, KM.G., Wang, M.Y., Virk, M.S., Dimar II, J.R., Mummaneni, P.V. (eds) Treatment of Spine Disease in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-031-12612-3_20

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