The common types of spinal infections are

Pyogenic infection

This type of infection occurs due to bacteria such as staphylococcus and streptococcus. Infection usually spreads to vertebra through blood from distant sites such as throat, lungs etc. The bacteria seed into the vertebra resulting in osteomyelitis.
The presentation of this type of infection is acute with patient presenting with severe back pain, muscle spasm and high-grade fever. Blood investigations including culture, x-rays, MRI scan, bone scan and biopsy aid diagnosis. Most of the patients would respond to rest and intravenous antibiotics. In few cases surgical debridement may be necessary.

Tuberculosis of spine

This type of infection is common and occurs either due to mycobacterium tubercle or atypical mycobacteria. There is destruction of paradiscal part of vertebral body with formation of abscess called as ?cold abscess?. Unlike pyogenic bacterial infections this is a slow process.
Patients present with back pain, low-grade fever, anorexia and loss of weight. An abscess may compress the spinal cord resulting in weakness and loss of bladder and bowel control. In neglected cases patient may develop angular deformity due to destruction of vertebral bodies called as kyphosis. Blood test, x-rays, MRI scan and biopsy aid diagnosis. Treatment includes taking anti-tuberculous medication religiously. This may be required for a period of one year with four drugs being prescribed for the first two months and then two drugs for the remaining period. Drugs have side effects and it is important to monitor liver function tests. One of the drugs called Rifampicin causes discoloration of urine. Drugs are effective in control of disease. A brace is used to protect the spine during treatment period. Patients who do not respond to medical treatment and those who develop neurological deficit inspite of treatment need surgery. Surgery involves drainage of abscess, debridement and stabilization using bone graft or implants.