Urgent referral to orthopedics is recommended for immediate evaluation and intervention.
Causes / typical injury mechanism:
- Pediatric disk space infection is often caused by hematogenous spread of bacteria, commonly associated with systemic infections or conditions.
- Injury mechanisms include trauma, surgeries, or infections that may introduce pathogens into the vertebral disk space.
- Patients may present with back pain, refusal to move the spine secondary to pain, and localized tenderness.
- Fever, irritability, and neurologic symptoms can accompany the presentation, indicating potential disk space involvement.
- Age – Occurs in individuals ages 20 years or younger due to residual vascular supply in the disk. There is a bimodal distribution of ages affected: 60% occurs between ages 6 months to 4 years and 40% occurs between ages 10-14 years.
- Sex / gender – Both sexes are affected, with only a slight predilection for males reported.
Pathophysiology:
- The causative pathogen is either directly inoculated into disk space (via trauma or invasive procedure) or through hematogenous spread from another site of infection.
- Most commonly occurs in the lumbar spine because of the rich vascular supply from the Batson venous plexus.
- The most common cause of pediatric disk space infection is Staphylococcus aureus.