Inflammation of the intervertebral disc in the cervical spine

The cervical spine in the human body is a very sensitive area. An inflammation of the intervertebral disc at this height results in extremely severe limitations for those affected. The cervical spine moves very strongly in everyday life and almost every eye movement is involuntarily accompanied by movement in the cervical spine.

In the case of an inflammation of the intervertebral disc, this pain is therefore permanently felt. A cervical collar can stabilize the neck during treatment and limit the freedom of movement. The antibiotic therapy for an inflammation of the intervertebral disc in the cervical spine is extremely important, as otherwise the bacterial pathogens can spread and spread to surrounding organs. Especially in the neck there are some vital pathways and organs.

Therapy

In the therapy of uncomplicated intervertebral disc inflammation, antibiotic treatment and immobilization of the affected area is the main focus. In addition, a supply of painkillers and anti-inflammatory (antiphlogistic) substances should be provided. If nerve damage or signs of entrapment are already present, or if the infection cannot be controlled in any other way, surgical treatment is required.

The main component of conservative therapy for intervertebral disc inflammation is antibiotic treatment over several weeks. This should, except in emergencies, such as septic progression, always only after determination of the pathogen and resistance testing. This is supplemented by several days of immobilization in bed rest.

The affected area should then be stabilized for several weeks with a corset or orthosis to prevent further irritation. If the disc inflammation affects the area of the lower lumbar spine, a considerably longer period of bed rest of approx. 6 – 12 weeks is necessary, since immobilization cannot be achieved otherwise.

Therefore, the surgical procedure is often preferred. The total treatment period can last up to one year. If after 4-6 weeks of conservative therapy there is no bony development of the affected area, or the infection persists, surgery is usually necessary.

The therapy of an inflammation of the intervertebral disc must be largely medicated. A distinction must be made between causal and symptomatic therapy. Both should take place, whereby the former is indispensable in the treatment of the intervertebral disc inflammation.

The main cause of the inflammation is a metastasis of bacterial pathogens. These are often persistent and spread further in their environment. Over time, severe inflammatory metastases occur and in the worst case, colonization of the blood and life-threatening complications.

Antibiotics must be used to contain the bacterial inflammation. There are antibiotics that have a very broad effect against a large number of pathogens. In particularly acute cases, these are used first.

However, they have disadvantages compared to targeted agents, since a pathogen-specific antibiotic is more effective and less often leads to the development of resistance in bacteria. With the help of blood samples and also tissue samples of the intervertebral disc, the causative pathogens must be obtained and identified. Only then can the most suitable antibiotic be selected and administered.

In the hospital, this is mainly given intravenously via an infusion, since this way more active substance reaches the intervertebral disc and lower doses are necessary.In the case of inflammation of the intervertebral disc, the intravenous antibiotic must in many cases be administered for up to 4 weeks. The entire therapy takes several months. In addition to the antibiotics, painkillers are also used in the therapy of intervertebral disc inflammation.

Due to the long healing period, the pain must be made as bearable as possible. Initially, naturopathic remedies can be used. For moderately severe pain, drugs from the group of NSAIDs are used, for example ibuprofen or diclofenac.

For extremely severe pain, opiates can also be administered, for example morphine. Homeopathy represents an alternative medical approach to healing, in which not a disease is to be treated, but the holistic person. Homeopathic remedies are highly diluted active ingredients, for example in the form of globules, which, when taken, are supposed to stimulate the body’s self-healing powers.

In case of an acute inflammation of the intervertebral disc, the globules can be used as a supplement to the antibiotics. It is extremely important to take antibiotics in this disease. In this case the globules do not represent an independent therapy alternative.

They can only support the inner healing powers when the inflammation subsides and the pain is processed. In the thoracic or lumbar spine area, both surgical and conservative therapies are possible, in the sacral area surgery is always indicated. The aim of surgical treatment is on the one hand to clear out the focus of the infection (wound debridement) and on the other hand to stabilize the spinal column.

Stabilization is achieved by a so-called spondylodesis, sometimes with additional implantation of bone tissue, e.g. from the iliac crest. Individual vertebral bodies are connected with each other by means of screws and plates, or replaced by titanium implants. After the operation, the natural mobility of the spine is thus completely or partially restricted.

In general, surgical treatment can be performed either in one operation or in two operations. In the latter case, only the infectious tissue is removed first, and then, after a short healing phase, the spine is stabilized in a further operation. The exact surgical method depends on the extent of the damage and the patient’s condition.

The operation can be performed either from the front, i.e. via the abdomen as the access route, or from the back. Overall, the surgical procedure offers the advantage of shortening the period of complete immobilization in cases of disc inflammation. With conservative therapy, this bears in particular the risk of degeneration of the holding muscles and the formation of so-called pseudarthroses (false joints) with malpositions of the spine.

The risk of thrombosis also increases with long periods of bed rest. However, even after the operation, immobilization for about 8 weeks is necessary until the wound has healed sufficiently. In addition, further treatment with antibiotics for about 12 weeks is recommended.