Diskitis
Disk inflammation
Diskitis is swelling (inflammation) and irritation of the space between the bones of the spine (intervertebral disk space).
The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.
The vertebral column is made up of 26 bones that provide axial support to the trunk. The vertebral column provides protection to the spinal cord that runs through its central cavity. Between each vertebra is an intervertebral disk. The disks are filled with a gelatinous substance, called the nucleus pulposus, which provides cushioning to the spinal column. The annulus fibrosus is a fibrocartilageous ring that surrounds the nucleus pulposus, which keeps the nucleus pulposus in tact when forces are applied to the spinal column. The intervertebral disks allow the vertebral column to be flexible and act as shock absorbers during everyday activities such as walking, running and jumping.
Causes
Diskitis is an uncommon condition. It is usually seen in children younger than 10 years and in adults around 50 years of age. Men are more affected than women.
Diskitis can be caused by an infection from bacteria or a virus. It can also be caused by inflammation, such as from autoimmune diseases. Autoimmune diseases are conditions in which the immune system mistakenly attacks certain cells in the body.
Disks in the neck and low back are most commonly affected.
Symptoms
Symptoms may include any of the following:
- Abdominal pain
- Back pain
- Difficulty getting up and standing
- Fever (typically 102°F or 38.9°C or lower)
- Increased curvature of the back
- Irritability
- Neck pain
- Sweating at night
- Recent flu-like symptoms
- Refusal to sit up, stand, or walk (younger child)
- Stiffness in back
Exams and Tests
Treatment
The goal is to treat the cause of the inflammation or infection and reduce pain. Treatment may involve any of the following:
- Antibiotics if the infection is caused by bacteria
- Anti-inflammatory medicines if the cause is an autoimmune disease
- Pain medicines such as NSAIDs
- Bed rest or a brace to keep the back from moving
- Surgery if other methods don't work
Outlook (Prognosis)
Children with an infection should fully recover after treatment. In rare cases, chronic back pain persists.
In cases of autoimmune disease, the outcome depends on the underlying condition. These are often chronic illnesses that need long-term medical care.
Possible Complications
Complications may include:
- Persistent back pain (rare)
- Side effects of medicines
- Worsening pain with numbness and weakness in your limbs
When to Contact a Medical Professional
Contact your provider if you or your child has back pain that does not go away, or problems with standing and walking that seem unusual for the child's age.
References
Mathew R, Hong DK. Diskitis. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 77.
Williams KD. Infections and tumors of the spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 42.
Version Info
Last reviewed on: 9/20/2022
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
