Spinal infections

Spinal infection is a serious and increasingly concerning condition within orthopedics and infectious diseases, with a gradually rising incidence in recent years. This trend is closely associated with the aging population, an increase in invasive spinal diagnostic and therapeutic procedures, a growing immunocompromised population, and the prevalence of drug-resistant strains. Due to the atypical early symptoms of spinal infection, along with the diversity of causative pathogens and the deep-seated location of the infection, clinical misdiagnosis or delayed treatment is common. In severe cases, spinal infection can lead to vertebral destruction, spinal deformity, neurological impairment, and even paralysis, imposing a heavy burden on patients and society. This article aims to systematically summarize the current general understanding of spinal infection, with an emphasis on its epidemiological characteristics, distribution of common pathogens, typical and atypical clinical manifestations, the diagnostic value of imaging and laboratory tests, strategies for etiological identification, and the principles of selecting medical versus surgical treatment. By integrating existing evidence and clinical experience, this review is expected to provide clinicians with a systematic diagnostic approach and treatment reference when facing suspected or confirmed cases of spinal infection, thereby improving early recognition and patient prognosis.