Spinal Osteomyelitis Surgery

Spinal Osteomyelitis, also known as Vertebral Osteomyelitis, is a rare and serious spine infection which occurs in your vertebrae (Cleveland Clinic, 2025). It has remained a persistent medical issue well into the twenty-first century. It is a condition that can stealthily progress and cause pain, neurological damage, and even life-threatening complications. This disease typically occurs when bacteria or fungi reach the spine through either the bloodstream or through a nearby infection.

According to Columbia Neurosurgery in New York City (2024), symptoms may include the following: back pain, unexplained weight loss, fever and chills, fatigue, swelling or pain around the area of infection, and torticollis (defined as the inability to straighten one's neck).

Although not all spinal infections require surgery, according to Chen et al. (2006), Vertebral Osteomyelitis responds well to conservative treatments in its early stages. However, as the symptoms progress and become more complicated, surgical intervention is usually required. This is typically the case when the infection causes abscesses, spinal instability, or neurological deficits, or when the patient has stopped responding to treatments, such as antibiotics. 

This surgery involves highly specialized procedures, often requiring a combination of debridement, drainage of abscesses, and spinal reconstruction. According to Chen et al. (2006), debridement (the removal of excess tissue) and autogenous strut grafting have since become a standard procedure for cases such as these. There are different approaches depending on the location of the infection and its severity:

• Anterior Decompression & Fusion - This procedure involves direct access to the damaged vertebrae. The infected bone is removed, and the spine is rebuilt using grafts infused with antibiotics (Kostuik, J. P., 1983)

• Posterior Stabilization - If the spine has weakened due to the infection, surgeons may opt for this approach. It involves inserting pedicle screws and rods to stabilize the spine while the infection heals (Hee et al., 2002).

• Minimally Invasive Techniques - These usually involve CT-guided drainage of abscesses or screws to minimize tissue damage. 

The recovery process typically involves six weeks of IV antibiotics that are administered based on the type of bacteria, in addition to bracing and physical therapy to help regain the body's function.

Patients diagnosed with Spinal Osteomyelitis have higher chances of recovery than ever before, and it is all because of this high-stakes, yet life-saving procedure. For anyone experiencing persistent back pain with fever or maybe neurological symptoms, seek medical attention immediately to get an early diagnosis and prevent irreversible damage.

Written by Sophia Perez at Incisionary

APA References

Cleveland Clinic. (2025, June 2). Vertebral Osteomyelitis. https://my.clevelandclinic.org/health/diseases/22276-vertebral-osteomyelitis. Retrieved on August 16, 2025.

Chen, W., Jiang, L., & Dai, L. (2006). Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation. European Spine Journal, 16(9), 1307–1316. https://doi.org/10.1007/s00586-006-0251-4. Retrieved on August 16, 2025.

Columbia Neurosurgery in New York City. (2024, January 3). Osteomyelitis Diagnosis & Treatment. https://www.neurosurgery.columbia.edu/patient-care/conditions/osteomyelitis#:~:text=if%20a%20prosthetic%20joint%20has,to%20fuse%20together%20(fusion). Retrieved on August 16, 2025. 

Kostuik, J. P. (1983). Anterior spinal cord decompression for lesions of the thoracic and lumbar spine, techniques, new methods of internal fixation results. Spine, 8(5), 512–531. https://doi.org/10.1097/00007632-198307000-00008

Hee, H. T., Majd, M. E., Holt, R. T., & Pienkowski, D. (2002). Better treatment of vertebral osteomyelitis using posterior stabilization and titanium mesh cages. Journal of Spinal Disorders & Techniques, 15(2), 149–156. https://doi.org/10.1097/00024720-200204000-00010