Introduction to vertebral osteomyelitis in adults

Vertebral osteomyelitis (also referred to as discitis and spondylodiscitis) primarily occurs in older adults. It is caused by haematogenous seeding of the vertebral end-plate, invasion of the avascular disc, and subsequent destruction of the adjacent vertebral bodies. Secondary spinal epidural abscesses (infections between the thecal sac of the spinal cord, the spinal ligaments and vertebrae) and paraspinal collections often develop; however, spinal epidural abscess can also occur in the absence of vertebral osteomyelitis. For treatment of spinal epidural abscesses that present in the absence of vertebral osteomyelitis, see Spinal epidural abscess. Vertebral osteomyelitis can follow spinal surgery.

For advice on managing vertebral osteomyelitis in adults, including choice of empirical antibiotic regimens, see Approach to managing vertebral osteomyelitis in adultsTurner, 2019.