Symptoms
Patients express particularly severe back pain in the acute phase of the inflammation. They describe this pain as throbbing and pulsating, as well as a feeling of congestion and pressure in the area of the affected vertebral body segment. Often the pain increases with movement, especially the turning and tilting of the head leads to stress-related back pain.
They can also radiate into the arms or contribute to headaches. The surrounding musculature may feel hardened. If the inflammation continues to progress and eventually attacks the spinal cord including the nucleus pulposus and fibrous ring, it can also lead to neurological deficits in these more serious cases.
Destroyed parts of the gelatinous core and the fibrous ring can eventually put pressure on the spinal nerves. Symptoms such as sensory disturbances can occur in the arms but also in the legs, depending on the extent of the damage. The movement of the individual extremities can be restricted to varying degrees.
Laboratory-chemically, an increase in the classic inflammation parameters in the blood is shown. These include C-reactive protein, blood sedimentation rate (BSG) and the leukocytes. In addition, there is fever, which, depending on the severity of the inflammation, can rise sharply and can be recurrent.
Diagnosis of an inflammation of the cervical vertebra
After a detailed questioning of the patient about his acute complaints and subsequent clinical examination, an x-ray should be taken to either exclude the suspected diagnosis of spinal inflammation or to confirm the diagnosis. If the inflammation is confirmed, the x-ray image will show extensive defects of the base and top plate. Spondylodiscitis can be detected much earlier in magnetic resonance imaging of the cervical spine or skeletal scintigraphy.
These two methods are significantly more sensitive and the overall extent of any deformities and degenerative processes can be better assessed. In the case of a bacterially triggered infection, the pathogens can be determined by applying a blood culture. Another possibility is the puncture of the inflammation, which should be performed during a computer or magnetic resonance tomography because of the sensitivity and the course of numerous nerves and vessels. The determination of the germs is relevant in order to subsequently initiate a therapy with the right antibiotic. In case of a suspected infection caused by tuberculosis pathogens, the examination of sputum of the lung and gastric juice is also useful.
