Acute Spinal Infections: A Modern Narrative Review With Evidence Through 2024

Abstract

Spinal infections are serious conditions affecting either the spinal canal or surrounding structures (e.g., vertebrae, the intervertebral discs or paraspinal tissues) and are caused by different organisms including bacteria and fungi. The most common mechanism is either hematogenous spread or after surgical procedures. It is important to make a prompt diagnosis based on clinical manifestations, as well as supporting laboratory and imaging testing. Depending on the localization and the severity of the spinal infections, management is either conservative, with antimicrobials in neurologically stable patients with no signs of spinal instability, or additional surgical treatment when there is spinal cord compression or instability. Early diagnosis and treatment remain crucial to avoid serious complications and poor outcomes.