The spectrum of intervertebral disc-space infection in children.

Discitis, intervertebral disc-space infection, and vertebral osteomyelitis form a spectrum of disorders with a probably common bacterial etiology. We studied forty-one children who had symptomatic narrowing of the disc space associated with fever and an elevated erythrocyte sedimentation rate and found that the diagnosis of infection in the spine was usually delayed. Technetium 99m polyphosphate bone-scanning proved to be an accurate, rapid, and safe method of establishing an early diagnosis of infection. A positive culture of blood or biopsy material was found in 34 per cent of all the patients (half of the patients for whom cultures were obtained). The clinical and roentgenographic picture that develops is determined both by the virulence and extent of infection and by the resistance and regenerative capacity of the host. Discitis in children is a vertebral osteomyelitis with disc involvement.