A spinal infection rarely affects the nerves in the spine. However, the infection may move into the spinal canal and cause an epidural abscess, which can place pressure on the neural elements. If this happens in the cervical or thoracic spine, it can result in paraplegia or quadriplegia. If it happens in the lumbar spine it can result in cauda equina syndrome (a syndrome that leads to bowel and bladder incontinence, saddle anesthesia, and possible lower extremity weakness).
In the past, tuberculosis infections caused by Mycobacterium Tuberculosis were very common. In North America, this type of infection is not common anymore, but it remains a common organism and cause of spinal infections in countries where there is a lot of poverty. Intravenous drug users are more likely than other patients to contract Mycobacterium Tuberculosis.
Symptoms vary depending on the type of spinal infection but, generally, pain is localized initially at the site of the infection. In postoperative patients, these additional symptoms may be present:
- Severe back pain.
- Painful or difficult urination.
- Muscle spasms.
- Neurological deficits.
Patients may initially have very few symptoms, but eventually develop severe back pain. Generally, younger, preverbal children do not have a fever nor seem to be in pain, but they will refuse to flex their spines. Children ages 3 to 9 typically present with back pain as the predominant symptom.