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Spinal abscess


Synonym(s): spine vertebra vertebral abscess abscessation osteomyelitis discospondylitis diskospondylitis

Introduction

  • Bacterial infection and subsequent abscess formation of the vertebral bodies and/or intervertebral disc, with or without extension into the spinal canal and compression or trauma of the spinal cord.
  • Cause: hematogenous spread from a primary site of bacterial infection.
  • Signs: depends on location of lesion. Ranges from pain, ataxia and loss of sensation to paralysis
  • Diagnosis: clinical signs, predisposing risk factors, neurological examination, diagnostic imaging, post-mortem examination.
  • Treatment: antibiotics and analgesia, surgical curettage has been successful.
  • Prognosis: poor.

Presenting signs

  • Depends on the location and extent of the abscess.
  • Ranges from reluctance to move and stiff gait to ataxia and inability to stand.

Acute presentation

  • Inability to stand and loss of deep pain sensation.

Geographic incidence

  • Worldwide.

Age predisposition

  • Most commonly diagnosed in young calves but also occurs in adults.

Cost considerations

  • Consider severity of clinical signs and prognosis before embarking on expensive diagnostic procedures or treatments.

Pathogenesis

Etiology

  • Bacterial infection of the vertebrae or intervertebral disc with subsequent abscess formation.
  • Usually form secondary to a primary focus of infection, eg navel ill , lung abscessation, infected injection site, foot lesion) via hematogenous spread.
  • Can be the result of direct extension from a primary insult, eg injection into the neck muscle extending into the vertebral column, epidural injection Epidural or tail docking.
  • May result from external trauma to the vertebral column.
  • Association with parasitic migration, and invasion from abscesses in surrounding structures have also been reported.
  • Trueperella pyogenes Trueperella pyogenes is most commonly isolated but this may not necessarily be the primary bacterial cause. Pasteurella spp Pasteurella multocida, Fusobacterium necrophorum Fusobacterium necrophorum, Streptococcus spp Streptococcus spp and Salmonella dublin Salmonella spp have all been cultured from these lesions.

Predisposing factors

General

Specific

Pathophysiology

  • A primary focus of infection, eg navel ill, may produce septic emboli.
  • The vertebral vascular anatomy, and pressure and flow rate of blood in the vertebral venous system creates a tendency for vascular stasis which provides ideal conditions for the lodging of an embolus.
  • The septic emboli lodge in the intervertebral discs or in the body of the vertebrae causing osteomyelitis +/- diskospondylitis and abscess formation.
  • Large abscesses can compress the spinal cord and cause degeneration of nerves. There may also be an associated meningitis.
  • Remodeling and proliferation of the vertebral bone secondary to the infection can also lead to further narrowing of the spinal canal and compression of the spinal cord.

Timecourse

  • Abscesses can take weeks - months to form and develop before clinical signs are seen.

Epidemiology

  • Sporadic.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Braun U, Schweizer G, Gerspach C & Feige K (2003) Clinical findings in 11 cattle with abscesses in the thoracic vertebrae. Vet Rec 152 (25), 782–4 PubMed.
  • Finley G G (1975) A survey of vertebral abscesses in domestic animals in ontario. Can Vet J 16 (4), 114-7 PubMed.
  • Frederick J D, Mackay R J, Winter M D & Castleman W L (2009) Vertebral osteomyelitis with abscessation in a Holstein calf. Vet Rec 164 (23), 723–4 PubMed.
  • Healy A M, Doherty M L, Monaghan M L & McAllister H (1997) Cervico-thoracic vertebral osteomyelitis in 14 calves. Vet J 154 (3), 227–32 PubMed.
  • Sherman D M & Ames T R (1986) Vertebral body abscesses in cattle: a review of five cases. JAVMA 188 (6), 608–11 PubMed.
  • Sherman D M (1987) Localized diseases of the bovine brain and spinal cord. Vet Clin North Am Food Anim Pract (1), 179–91 PubMed.
  • Zani D D, Romanò L, Scandella M et al (2008) Spinal epidural abscess in two calves. Vet Surg 37 (8), 801–808 PubMed.

Other sources of information

  • Buergelt C D, Clark E G & Del Piero F (2017) Bovine Pathology: A Text and Colour Atlas. CAB International. pp 51.
  • Craig L E, Dittmer K E & Thompson K G (2017) Pathology of Domestic Animals. 6th edn. Elsevier, USA. pp 103.
  • Diver T J & Peek S F (2008) Rebhun’s Diseases of Dairy Cattle. 2nd edn. Saunders Elsevier, USA. pp 535-537.
  • Miller A D & Zachary J F (2017) Pathologic Basis of Veterinary Disease. 6th edn. Elsevier, USA. pp 837.
  • Radostits O M, Gay C C, Hinchcliff K W & Constable P D (2007) Veterinary Medicine. 10th edn. Elsevier, USA. pp 787.