What is Discitis?
Discitis is an inflammation of the intervertebral disc space, which can be caused by infections, autoimmune responses, or other inflammatory processes. This condition often affects the vertebral bones and the spinal cord, leading to severe pain and mobility issues.
Histological Characteristics
In histological terms, discitis is characterized by the presence of
inflammatory cells such as polymorphonuclear leukocytes, lymphocytes, and plasma cells. These cells infiltrate the disc space and adjacent vertebral endplates. The
intervertebral disc shows evidence of degeneration, including loss of the normal architecture of the
annulus fibrosus and the
nucleus pulposus.
What Causes Discitis?
Discitis can be caused by bacterial or fungal infections, which can reach the disc through the bloodstream, direct inoculation during surgery, or spread from adjacent infected tissues. Common pathogens include
Staphylococcus aureus,
Escherichia coli, and Mycobacterium tuberculosis. Non-infectious causes may involve autoimmune diseases or chronic inflammatory conditions.
Histopathological Examination
A histopathological examination is crucial for diagnosing discitis. Biopsy samples of the affected disc space are stained and examined under a microscope.
Hematoxylin and Eosin (H&E) staining is commonly used to visualize cellular components and tissue architecture. The presence of inflammatory cells, necrosis, and granulation tissue are key indicators of discitis in histological samples.
Clinical Symptoms and Diagnosis
Patients with discitis typically present with severe back pain, fever, and restricted mobility. Laboratory tests may show elevated inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Imaging studies, including MRI and CT scans, can reveal disc space narrowing, endplate erosion, and paravertebral abscess formation. However, histological analysis remains the definitive method for diagnosing the underlying cause of discitis.Treatment Options
The treatment of discitis depends on the underlying cause. For bacterial infections, long-term antibiotic therapy is essential, sometimes necessitating intravenous administration. In cases of fungal infections, antifungal medications are used. For non-infectious discitis, anti-inflammatory drugs and immunosuppressive agents may be prescribed. Surgical intervention might be required in severe cases to debride infected tissue or stabilize the spine.Prognosis and Complications
The prognosis for discitis varies depending on the cause and promptness of treatment. Early and appropriate intervention generally leads to a good outcome. However, delayed treatment can result in chronic pain, spinal deformities, and neurological deficits due to spinal cord compression. Histological monitoring may be necessary to assess treatment efficacy and detect any recurrence or complications.
