For appointments or confidential discussion call
London Clinic 07776 511824
Norwich Clinic 01603 505063

The London Norwich Spine Clinic is based at
Hospital of St Johns & St Elizabeth, St Johns Wood, London
and the Spire Norwich Hospital, Norwich.

Information for GPs

Your spine is one of the most important and complex parts of your body - keeping it healthy is vital if you want to lead an active and pain free life.

Spinal Infections

Otherwise know as vertebral osteomyelitis is a rare cause of spinal pain but if not treated can cause devastating symptoms.


Spinal infections may occur following surgery or spontaneously in patients with certain risk factors, including:

  • A weak immune system (including patients with HIV)
  • Cancer (especially following radiotherapy)
  • Poor nutrition
  • Diabetes
  • Obesity


  • Persistent back pain, even when resting, sometimes accompanied by muscle spasms
  • Fever and chills
  • Headache
  • A stiff neck


As patients often have vague symptoms, an accurate diagnosis can be delayed. The consultant will look at the patient's case history.

  • An MRI scan can confirm the location of the infection
  • A sample taken from the infected area is examined to identify the type of bacteria or fungus

Treatment options

Non surgical

Bed rest and course of appropriate antibiotics. Medication is taken orally or via a drip - course duration ranges from weeks to months depending on type and severity of infection.

Wearing a back brace to support the spine.

These treatments are successful in about 75% of patients.


An operation may be required if other treatment has failed or the following is present:

  • Increasing neurological impairment ie weakness of arms and legs which can lead to paralysis
  • Spinal abscess
  • Severe pain, even when not moving
  • Progressive spinal deformity
  • Major instability in the spine

Surgery usually involves removing the diseased tissue or bone and stabilising the spine with screws , metal rods and cages if needed.

"Mr S is now symptom free and back to working within the building trade." Read case studies >

Case studies

Mrs C, aged 74

Condition: Infection of the thoracic spine

Treatment: Excision of infected bone and reconstruction of the spine using instrumentation

Mr Rai's notes

"Most infections of the spine can be treated with antibiotics but occasionally the infection can destroy the bone causing weakness, paralysis and severe pain. This case illustrates the need for appropriate, prompt aggressive surgery to restore normal function.

Mrs C was 74 year old lady that presented late with severe pain in the chest and weakness in her legs. She was initially admitted to another hospital and treated with antibiotics. However within a weak her legs became weak such she could not walk. She was referred to our hospital for a specialist spinal opinion.

Her pre op MRI shows how the infection is destroying the thoracic vertebrae with pressure on the spinal cord. If left untreated it is likely that her paralysis would be permanent and the infection would spread.

She underwent a staged surgical procedure with an anterior thoracotomy, excision of the infected material, reconstruction with a titanium cage followed by posterior instrumentation. The procedure took 7 hours to perform.

The post op x-ray shows the reconstruction and at 3 months post op she is able to walk and leads a independent life.

Spinal infection pre-op
Spinal infection post-op
Spinal infection post-op

Mr S, aged 51

Condition: Spinal Infection

Treatment: Surgery to remove infected bone

Mr Rai's notes

"Mr S was initially admitted to hospital with pneumonia but as that improved he developed constant back pain that kept him up at night with mild weakness of his legs

An MRI scan showed a mild spinal infection so initial treatment was conservative with antibiotics, a lumbar corset and some gentle physiotherapy.

However, 2 weeks later, Mr S had increasing neck pain, plus pins and needles and difficulty walking. The infection had spread and was causing pressure on the spinal cord. If left untreated, there was a high chance that the pressure would build up on the spinal cord and potentially cause paralysis. Therefore a operation was recommended.

Surgery involved removing the infected bone to take pressure off the spinal cord. Screws then were placed in from behind to further strengthen and stabilise the spine.

Mr S is now symptom free and back to working within the building trade."

Spinal infection pre-op
Spinal infection post-op