True infections are uncommon, particularly in the industrialized countries of the world.
The estimated annual frequency is 0.037 for disc space infection, 0.037 for bacterial vertebral osteomyelitis and 0.037 epidural abscesses . A certain group of people are at risk. The symptoms vary with the particular disease but constant back pain without a history of trauma is worrisome. Often there is a delay in diagnosis because of the subtle presentation, the failure to appreciate unrelenting pain, and the absence of systemic signs such as temperature elevation. The laboratory study may be misleading, normal white blood cell counts are common, radiographs often show no abnormalities early in the course of the illness, and even more sensitive diagnostic tests such as bone scan s may not become positive for a week.