-
DE
M46.5 Spondylodiscitis – Causes, Symptoms, Treatment
M46.5 is the ICD-10 code for spondylodiscitis, a bacterial infection of the spine affecting the vertebral bodies and intervertebral discs.
Add as Preferred SourceThings worth knowing about "M46.5"
M46.5 is the ICD-10 code for spondylodiscitis, a bacterial infection of the spine affecting the vertebral bodies and intervertebral discs.
What is M46.5 (Spondylodiscitis)?
M46.5 is the ICD-10 classification code for spondylodiscitis, a serious infectious disease of the spine that simultaneously involves one or more vertebral bodies (spondylitis) and the adjacent intervertebral discs (discitis). Although relatively rare, spondylodiscitis is a potentially life-threatening condition that requires prompt diagnosis and treatment.
Causes
Spondylodiscitis is most commonly caused by bacteria that spread to the spine through the bloodstream (haematogenous spread). Less frequently, the infection arises from direct contamination, for example following spinal surgery or lumbar puncture.
- Most common pathogen: Staphylococcus aureus (including MRSA)
- Streptococcal species
- Gram-negative bacteria (e.g., Escherichia coli, Pseudomonas aeruginosa)
- Mycobacterium tuberculosis (Pott disease)
- Fungi (rare, mainly in immunocompromised patients)
Risk factors include advanced age, diabetes mellitus, renal insufficiency, immunosuppression, intravenous drug use, infections at other body sites (e.g., urinary tract infections, endocarditis), and prior spinal procedures.
Symptoms
Spondylodiscitis often has an insidious onset, which can delay diagnosis. Typical symptoms include:
- Severe, localised back pain that worsens with movement and persists at rest
- Tenderness on palpation over the affected vertebrae
- Fever and general malaise (not always present)
- Night pain
- In severe cases: neurological deficits such as numbness, limb weakness, or bladder and bowel dysfunction due to epidural involvement
Diagnosis
Diagnosis requires a combination of clinical assessment, laboratory tests, and imaging:
- Blood tests: Elevated inflammatory markers (CRP, ESR, white blood cell count), blood cultures for pathogen identification
- MRI of the spine: The imaging method of choice – detects early inflammation, oedema, and possible abscesses
- CT scan: Used additionally to assess bone destruction
- Biopsy / CT-guided puncture: To obtain samples for microbiological analysis and targeted antibiotic therapy
- Scintigraphy or PET-CT: As supplementary imaging in ambiguous cases
Treatment
Conservative Treatment
The cornerstone of treatment is prolonged, pathogen-directed antibiotic therapy, typically lasting 6 to 12 weeks. It usually begins with intravenous administration before switching to oral antibiotics. Immobilisation of the spine through bed rest and orthoses is also recommended.
Surgical Treatment
Surgery is indicated when:
- Neurological deficits develop or worsen
- An epidural abscess is present
- Spinal stability is compromised (vertebral body collapse)
- Conservative treatment fails
The procedure typically involves debridement of infected tissue and abscess drainage, followed by spinal stabilisation (spinal fusion) if necessary.
Prognosis
When diagnosed early and treated consistently, the prognosis of spondylodiscitis is generally favourable. However, delayed diagnosis can lead to permanent damage, neurological deficits, or spinal deformities. Regular follow-up examinations, including MRI and inflammatory markers, are essential during and after treatment.
References
- Deutsche Gesellschaft für Neurologie (DGN): Guideline on Spondylodiscitis, 2021.
- Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. Journal of Antimicrobial Chemotherapy, 2010; 65(Suppl 3): iii11–iii24.
- Herren C, et al. Spondylodiscitis – Diagnosis and Treatment. Deutsches Ärzteblatt International, 2017; 114(51–52): 875–882.
Building Blocks for a Healthy Life
As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.
Skip product gallery
Subscription available
Floral
For Healthy Oral Flora & Dental Care
Formulated lozenges with Dentalac®, lactic acid bacteria, and Lactoferrin CLN®30 lozenges
Regular price:
22,90 €
Discount
Subscription available
Lactoferrin 60 Capsules
For your universal protection
As one of the most valuable proteins in the body, lactoferrin is a natural component of the immune system.
60 Capsules
Sale price:
50,00 €
Regular price:
59,90 €
Subscription available
Multivitamin Mineral Complex
Daily basic supply: the complete spectrum of micronutrients
Natural multivitamin complex for the immune system, energy, and central body functions
30 Capsules
Regular price:
29,90 €
Subscription available
Natural Iron
For your iron balance
Specially formulated for your iron balance with plant-based curry leaf iron, Lactoferrin CLN®, and natural Vitamin C from rose hips.
30 Capsules
Regular price:
35,90 €