Spondylitis is one of the rare inflammatory diseases in Europe. According to statistics, less than 22 people per 1 million per year suffer from spondylitis.
In most cases, the inflammation is caused by a bacterial infection in the spine. The vertebral bodies are particularly affected.
In some cases, the inflammation spreads to the bone marrow - doctors refer to this as osteomyelitis.
Other special forms of spondylitis are
- Tuberculosis spondylitis: is caused by tuberculosis,
- Spondylitis brucellosa: is caused by brucellosis,
- ankylosing spondylitis: chronic inflammatory spinal disease known as ankylosing spondylitis.
Spondylitis is caused by bacteria or fungi that enter the spine or vertebral bodies. The main routes of infection are
- the blood
- the lymphatic system and
- injections and punctures, e.g. after an injury.
People who suffer from spondylitis / spondylodiscitis are often older. Therefore, older age is one of the risk factors for the development of these diseases.
Various concomitant diseases (comorbidities) also favor spondylitis, including
Ankylosing spondylitis, on the other hand, belongs to the group of rheumatic diseases. People with the HLA-B27 gene have a higher familial risk of developing this autoimmune disease. However, the exact cause of the development of ankylosing spondylitis is still unknown.
Spondylitis is characterized by inflammation of the spine. The vertebral bodies are often affected © bilderzwerg | AdobeStock
In the early stages, spondylitis is usually asymptomatic. As the disease progresses, it eventually leads to pain, which is mainly localized in the affected vertebral segment. However, it can also radiate into the arms and legs.
Especially
- the lumbar vertebrae,
- the sacrum and
- and sometimes the cervical spine
are more frequently affected.
In addition, a general feeling of illness with fever and chills may occur. Sensory disturbances and/or restricted movement are also possible at an advanced stage.
If the disease remains untreated for a long period of time, inflammatory changes in the spine can occur, including the destruction of individual vertebral structures.
The medical examination always begins with a medical history interview. The doctor clarifies which symptoms have occurred since when. It is also important to find out whether there is a family history of the symptoms described and the possible diseases.
From this anamnesis interview, the doctors usually arrive at a selection of differential diagnoses. The doctor then clarifies characteristic symptoms and signs with the help of a physical examination, including inflammatory parameters and blood count.
At the end of these examinations, a suspected diagnosis is made .
The subsequent imaging should confirm this suspected diagnosis. If the pain in the spine is unclear, the X-ray is used first.
However, magnetic resonance imaging (MRI) is the method of choice for a reliable diagnosis of spondylitis. MRI allows much more detailed images to be taken. They make it possible to describe the spread and stage of the inflammation along the spine more precisely.
Depending on the stage of inflammation, spondylitis is treated conservatively with antibiotics. During this time, the spine can be stabilized and immobilized with a corset.
In the early stages of the disease, the main aim is to prevent the infection from spreading further. An operation on the spine can then be avoided.
However, surgery is necessary if the spondylitis has spread to the intervertebral discs and caused a purulent inflammation there - spodylodiscitis. The aim of the operation is to remove the focus of inflammation.
During the operation, the surgeons remove the affected disc and the impaired bone material of the vertebral body. The resulting gaps are filled with bone replacement material.
It is also necessary to take antibiotics after the operation.
The causes that ultimately trigger spondylitis are unknown. It is therefore not easy to prevent this inflammatory disease.
However, there are a few factors that are associated with an increased risk of spondylitis. You can prevent these factors:
If you consistently avoid or treat these risk factors and comorbidities, the risk of spondylitis is reduced.
Otherwise, if you have unclear back pain with or without fever symptoms, you should consult a specialist. If detected and treated early, spondylitis has a good prognosis in the majority of cases.
