Vertebral Osteomyelitis

Vertebral osteomyelitis is a rare spine infection that’s often caused by Staphylococcus aureus. It can happen after a surgery or by germs traveling from another infection site in your body. Risk factors include getting older and using dirty needles.


Your spine includes anterior and posterior longitudinal ligaments, the spinal cord, the arachnoid and dura matter.
Vertebral osteomyelitis is an infection in your spine that can happen as a result of injury, surgery or by transmission through your bloodstream from another site.

What is vertebral osteomyelitis?

Vertebral osteomyelitis is a rare spinal infection. Osteomyelitis, the name for a painful bone infection that develops from bacteria or fungi, is itself rare. Vertebral osteomyelitis can happen as the result of an injury to your spine or after surgery. It can also be spread from another place in your body to your spine in your bloodstream. Other names for this condition include spinal osteomyelitis and spondylodiskitis.


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Who is affected by vertebral osteomyelitis?

According to research, more men than women develop vertebral osteomyelitis. The chances of it happening increase as you get older.

You may be more likely to get vertebral osteomyelitis if you:

  • Are unwell and live in a nursing home.
  • Are on dialysis.
  • Have sickle cell disease.
  • Inject drugs using needles that aren’t sterile.

How common is vertebral osteomyelitis?

Studies estimate that vertebral osteomyelitis happens to about 4.8 per 100,000 people, with the rate increasing over time. One estimate is that 26,170 to 65,400 people in the U.S. develop the condition every year, but it’s hard to be exact because vertebral osteomyelitis is difficult to diagnose.


Symptoms and Causes

What are the signs and symptoms of vertebral osteomyelitis?

Signs and symptoms of vertebral osteomyelitis may include:

  • Back pain that gets worse when you move, and doesn’t get better with home treatments like taking pain relievers, applying heat or resting.
  • Weakness.
  • Numbness and tingling.
  • Weight loss.

You might not have a fever if you have vertebral osteomyelitis.

What causes vertebral osteomyelitis?

Germs cause vertebral osteomyelitis, and the most common cause is the bacterium Staphylococcus aureus, also known as staph. Staph itself is common. About 30% of the total population have staph in their noses without consequences. However, staph infections can be very serious when they do happen.

Other types of germs like fungi or Mycobacterium tuberculosis (the germ responsible for tuberculosis) can cause vertebral osteomyelitis.

If you break a bone or something pierces your bone, you can develop a bone infection. Blood can spread infections from nearby areas of soft tissue if they’re infected. Bedsores can lead to infections elsewhere in your body, including bones. So can urinary tract infections.


Is vertebral osteomyelitis contagious?

Bone infections like vertebral osteomyelitis aren’t contagious, but the germs that cause them are. You can pass the actual germs to another person.

Diagnosis and Tests

How is vertebral osteomyelitis diagnosed?

The symptoms of vertebral osteomyelitis can resemble those of other diseases. In addition to taking a medical history and examining you, your healthcare provider will order diagnostic tests such as:

  • Blood tests, such as ones to test for inflammation, like the erythrocyte sedimentation rate or a test for how much C-reactive protein is in your blood or how many white blood cells there are. Blood, tissue, pus and fluid from your joint and bone may be tested to find out what type of germ is causing the infection.
  • Imaging tests, such as magnetic resonance imaging (MRI) scans, computed tomography (CT) scans and X-rays, can show problem areas in your bones. Your healthcare provider might also order a bone scan.
  • Biopsy. In a biopsy, a surgeon removes tissue or a piece of bone to make a diagnosis, but also to decide which antibiotic would work best. In this case, your healthcare provider might use CT to guide the biopsy.

Management and Treatment

How is vertebral osteomyelitis treated?

Your healthcare provider will prescribe antibiotics to treat vertebral osteomyelitis. You may get both oral and non-oral forms. Typically, you’ll be treated for about six weeks.

Your healthcare provider might also suggest back braces to help keep your spine stable, along with rehabilitation to improve muscle strength.

You might need surgery to drain pus from the infected area, as well, or to stabilize your vertebrae so they don’t collapse.


How can I prevent vertebral osteomyelitis?

Men are more likely to develop vertebral osteomyelitis.

There are some risk factors you can influence, though, like:

  • Avoid injecting any drug that isn’t prescribed for you and avoid using dirty needles.
  • Manage diabetes by following instructions from your healthcare provider.
  • Avoid skin infections by taking care not to get scratched or cut. If you do have some type of wound, make sure you clean it well.
  • Follow a healthy lifestyle by eating well, exercising and getting enough sleep.

Outlook / Prognosis

What is the outlook (prognosis) for someone with vertebral osteomyelitis?

With treatment, you may recover from vertebral osteomyelitis in a month to six weeks. However, it might take up to six months for you to feel fully recovered.

Without treatment, you may develop severe spine damage or septicemia (blood poisoning from bacteria). Death occurs in about 20% of cases of vertebral osteomyelitis even though diagnosis and treatment have gotten better.

Living With

When should I contact my healthcare provider about vertebral osteomyelitis?

It’s best to seek treatment early. Contact your healthcare provider if:

  • You’ve just had surgery or have an infection, even one such as a urinary tract infection, and you feel pain in your neck or back that won’t stop no matter what you do.
  • You have a fever that isn’t controlled by medication.
  • You’ve had a dental procedure or have injected drugs and you have neck or back pain that isn’t getting better.
  • You’re recovering from vertebral osteomyelitis and symptoms are getting worse or you develop a new symptom.

A note from Cleveland Clinic

Vertebral osteomyelitis is a rare condition, but it does happen. It’s more likely to occur if you’re in poor health or have another type of infection. It’s important to contact your healthcare provider about back pain that doesn’t get better, even when you apply heat or take pain relievers. If you receive dialysis, inject drugs or have just had surgery and you have back pain that doesn’t improve, see your doctor immediately. The best outcome happens when vertebral osteomyelitis is diagnosed and treated early.

Medically Reviewed

Last reviewed on 01/10/2022.

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