Septic spondylitis is rare, accounting for 4% of all osteomyelitis. It occurs mostly in young adults, more in men than in women, and rarely in children and the elderly. The most frequent site of disease is the lumbar spine, followed by the thoracic spine and cervical spine. The pathogenic bacteria are mainly Staphylococcus aureus, other bacteria such as streptococcus, Staphylococcus albus, Pseudomonas aeruginosa, etc. can also cause the disease. The main cause of the disease is hematogenous infection, because the spinal venous system is located around the dura and the spine, and is a plexus without valves, which is an independent system outside the vena cava, portal vein, and odd vein, but has many traffic branches directly connected with the superior and inferior vena cava. The blood flow in the spinal venous system is slow and can be stagnant or even reflux. Therefore, bacterial emboli in either venous system can reach the spinal column. Dorsal penile venography reveals that the dorsal penile vein and prostatic venous plexus are connected to the spinal veins, so urinary tract infections can be combined with spinal infections. Traumatic injuries such as bullet penetration injuries can also cause secondary infections; medical operations such as lumbar puncture and spinal surgery can cause secondary infections. Bacteria from spinal infections reach the center or edge of the vertebral body and then spread to the vertebral arch, or they may first infect the vertebral arch and then spread forward to the spinal canal and vertebral body. This can produce symptoms of nerve root and spinal cord compression in the spinal canal, resulting in radicular neuralgia and paraplegia. Meningitis can also occur when the dura mater is penetrated. Infection of the vertebral body forms abscesses that spread to the surrounding soft tissues as in spinal tuberculosis, producing abscesses of the posterior pharyngeal wall, neck abscesses, and upper mediastinal abscesses in the cervical spine; abscesses of the psoas major muscle in the lumbar spine; and abscesses of the pelvic, paranal, and sciatic rectal fossa in the sacral spine. Few of them can spread to internal organs such as pericarditis, lung abscess and abscess chest, etc. Symptoms and signs 1. Acute systemic toxic symptoms or subacute manifestations such as chills, high fever, confusion, coma, vomiting and abdominal distension. Severe pain in the lumbar region, inability to turn over, and moaning and restlessness. 2.Spinal pressure pain, local percussion pain and spinal stiffness on physical examination. 3.Signs of nerve root irritation in the spinal canal such as segmental radiating pain, muscle spasm, etc., and limb paralysis. Diagnosis 1. Pay attention to the patient’s age, sex and location of onset. Ask whether there is any history of boils, carbuncles, tonsillitis or inflammatory diseases of the urinary system before the onset of the disease, and whether there is any history of spinal or intervertebral disc surgery or open injury. 2. Carefully inquire about the course of the disease and whether there are acute systemic symptoms or subacute manifestations such as chills, hyperthermia, confusion, coma, vomiting and abdominal distention. 3, pay special attention to local symptoms, whether there is severe pain in the lumbar region, inability to turn over, moaning and restlessness. Any spinal pressure pain, local percussion pain and spinal stiffness during physical examination. 4. Any signs of nerve root irritation such as segmental radiating pain, muscle spasm, etc. The presence of limb paralysis. 5.X-ray shows whether there is vertebral osteoporosis, whether the edges are blurred, whether there is narrowing of the vertebral space, as well as vertebral sclerosis, intervertebral bone bridge formation and vertebral fusion. 6, blood white blood cell count and classification, blood sedimentation and bacterial culture of blood and pus. Treatment 1, early joint application of high-dose antibiotics, and timely adjustment according to bacterial culture and drug sensitivity test results. After 1 month of intravenous administration, change to oral administration until symptoms disappear and blood sedimentation returns to normal. Strengthen supportive therapy (nutrition, fluid transfusion, blood transfusion, correction of water-electrolyte disorders). 2. In the acute stage, the patient should be strictly bedridden and can be fixed in a plaster bed or with a plaster lumbar girth according to the situation. The duration of immobilization should not be less than 3 months or until the blood sedimentation returns to normal. 3, surgical treatment is limited to: ① progressive aggravation of neurological symptoms; ② obvious bone destruction, spinal deformity and instability; ③ larger abscess formation; ④ recurrence of infection; ⑤ conservative treatment is ineffective.