Chiari malformation
What is it?
Inflammatory disorders of the spine can stem from various conditions, such as arthritis, osteoporosis, and infection. While spinal inflammation is uncommon, it can be a significant source of pain and disability, especially if these difficult-to-diagnose conditions are left untreated.
One of the most common spinal inflammatory disorders is ankylosing spondylitis, a form of arthritis in the spine. Other sources of spinal inflammation include arachnoiditis – an infection of the membrane surrounding the spinal cord, discitis – an infection in the space between vertebrae, and sacroiliitis – inflammation of the joint between the lower back and the pelvis.
Ankylosing spondylitis involves inflammation in the areas where soft tissue (ligaments and tendons) attach to bone. The inflammation starts in the lower back and the joint between the spine and the pelvis, which causes some of the tissue to erode. When the inflammation subsides, new bone may grow in its place. This progressive cycle of bony growth restricts movement, and it can result in complete fusion between two bones.
In patients with an infection, the cause of the inflammation is apparent. However, the origin of ankylosing spondylitis is unknown, although it is known to have a genetic component.
Symptoms
Spinal inflammation leads to back pain in patients. Infections may cause slow-onset severe pain and other symptoms such as fever and fatigue. Ankylosing spondylitis, another form of spinal inflammation, causes slow-onset pain, stiffness in the morning, and a stooped posture. The swelling and pain may spread to other joints and affect the heart, lungs, and eyes.
Diagnosis
When diagnosing inflammatory disorders of the spine, doctors usually start with a physical examination and blood tests to check for infections or inflammation. X-rays are also commonly used to check for changes in the spine. Additionally, patients with ankylosing spondylitis may undergo genetic testing, as a specific gene (HLA-B27) has been identified in 90% of patients with this condition.
Treatment
The treatment for an inflammatory disorder of the spine varies depending on its cause. If an infection causes inflammation, the treatment may include antibiotics, rest, and a brace. For patients with ankylosing spondylitis, anti-inflammatory medications, and muscle relaxants are often prescribed to manage pain and improve posture. Surgery may sometimes be needed to remove bony growths and reduce pressure on painful joints. A small percentage of these patients may also require a hip joint replacement.