Are Modic type 2 disc changes associated with low-grade infections? A pilot study

Drago, Lorenzo; Romanò, Carlo Luca; Cecchinato, Riccardo; Villafañe, Jorge Hugo; Vecchi, Elena De; Lamartina, Claudio; Berjano, Pedro

doi:10.23736/s0390-5616.17.03997-2

Cited by 9 publications

(18 citation statements)

References 20 publications

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“…Among our included studies, adequate culture time period up to 14 days or more is used in many of the studies [1,3,9,15,16,26,27,30]. Multiple culture mediums for the tissues were also used to prevent false-negative result [16, 26,27,33,34]. However, according to the meta-regression results, these differences among studies did not contribute to the heterogeneity of the pooled proportions.…”

Section: Discussionmentioning

confidence: 99%

“…Among the included papers that were analysed for the infection proportion of P. acnes, we found Arndt [33], Rigal [3], Drago [34], Chen [30] analysed the presence of Modic changes. The papers of Aghazadeh [11] and Zhou [6] which were excluded due to overlapped data in analysis of infection proportion were also included for assessment of Modic changes (Supplemental (Fig.…”

Section: Comparison Of Modic Change Between Positive Cultures and Negmentioning

confidence: 99%

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The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

et al. 2019

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Purpose The role of bacteria, especially Propionibacterium acnes (P. acnes), in human intervertebral disc diseases has raised attention in recent years. However, limited sample size of these studies and diverse bacteria-positive proportion made this topic still controversial. We aimed to review related articles and summarize the bacteria-positive proportion in these studies. Methods We searched the PubMed, Cochrane Library, Embase for related literature from January 2001 to May 2018, and the reference articles were also searched. The random effects or fixed effects meta-analysis was used to pool the overall positive proportion or odds ratio of these studies. ResultsWe found 16 relevant articles and 2084 cases of the bacteria culture from surgery. Within the 16 included studies, 12 studies' results supported the infection in the discs. The pooled bacterial infection rate was 25.3%. The pooled P. acnes infection rate was 15.5%. The overall pooled P. acnes proportion in bacteria-positive discs was 56.4%. We also found that the presence of bacteria may contribute to the development of Modic change with the odds ratio as 1.27 (95% CI: 0.44-3.64), but this result is not significant due to heterogeneity, so further study is needed. Conclusion The existence of bacteria in the intervertebral discs was proved by many studies. However, the variety in sample collecting and culture methods is still obvious and the positive rate also fluctuated within the studies. Standardized and reliable methods should be taken to promote the study in the future. Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.

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Section: Discussionmentioning

confidence: 99%

Section: Comparison Of Modic Change Between Positive Cultures and Negmentioning

confidence: 99%

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

et al. 2019

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“…Arndt and co-workers (2012) did not find differences when MC1 and MC2 were pooled and compared to MC-free samples; however, MC2 specimens alone showed greater bacterial positivity than other samples [ 41 ]. Drago and colleagues (2020) concluded MC2 may be associated with occult infection when samples from 6/16 (37.5%) MC2 patients and only 1/23 (4%) MC-free control returned positive bacterial cultures [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…MC1 adjacent discs have been proffered as inflammatory and most vulnerable to occult infection [14]; however, only study showed MC1 was associated with increased rates of disc bacterial growth [35]. MC specimens have been reported more infective than MC-free specimens [36][37][38][39] as have MC2 samples [41,42]. Increased immune activation in MC2 compared with MC-free samples has also been found, however, without examination of disc bacteria [60].…”

Section: Discussionmentioning

confidence: 99%

Evidence for infection in intervertebral disc degeneration: a systematic review

et al. 2021

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Purpose Back pain is a major problem worldwide and is linked to intervertebral disc degeneration and Modic change. Several studies report growth of bacteria following extraction of degenerate discs at spine surgery. A pathophysiological role for infection in back pain has been proposed. Method We conducted a PRISMA systematic review. MEDLINE, PubMed, Scopus and Web of Science were searched with the terms Modic change, intervertebral dis*, bacteria, microb*, and infect*. Date limits of 2001–2021 were set. Human studies investigating the role of bacteria in disc degeneration or Modic change in vertebrae were included. Results Thirty-six articles from 34 research investigations relating to bacteria in human degenerate discs were found. Cutibacterium acnes was identified in pathological disc material. A ‘candidate bacterium’ approach has been repeatedly adopted which may have biased results to find species a priori, with disc microbial evidence heavily weighted to find C. acnes. Conclusion Evidence to date implicates C. acnes identified through culture, microscopy and sequencing, with some suggestion of diverse bacterial colonisation in the disc. This review found studies which used culture methods and conventional PCR for bacterial detection. Further agnostic investigation using newer methods should be undertaken.

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“…At present, many treatment methods are well known, but the main problem is that these treatments are very expensive and non-speci c. On the other hand, the current biological agents can not relieve long-term pain without drug assistance. Another drug is oral antibiotics, and some scholars believe that intervertebral disc degeneration may be related to bacterial infection of intervertebral disc [6]. This may be due to the elimination of potential bacteria in the intervertebral disc [2], but the detection rate of cells in the intervertebral disc is not high in DLBP patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy And Dose Effect Of Intradiscal Injection Of Sustained-Release Simvastatin Hydrogel For Treatment Of Discogenic Low Back Pain In Rabbitsintradiscal 

Huang

Wang

et al. 2021

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Purpose: The aim of this study was to explore the efficacy and dose effect of intradiscal injection of simvastatin sustained release hydrogel in the treatment of discogenic low back pain in rabbits.Methods: 36 female rabbits were randomly divided into G1 and G2 groups. In group G1, L1/2 was disc degeneration (group DDD), L2/3 was normal group (control group), L3/4 was medium dose treatment group (1mg/ml, DDD+ medium group), L4/5 was normal group, L5/6 was intervertebral disc degeneration + hydrogel segment (medium group). In group G2, L1 / 2 was degenerative segment, L2 / 3 was normal group, L3 / 4 was low-dose treatment segment (0.3mg/ml, DDD + low-dose group), L4 / 5 was normal group, L5 / 6 was high-dose treatment segment (3mg / ml, DDD + high-dose group). The intervertebral disc was evaluated by X-ray, MRI, water content, and hematoxylin-eosin.Result: At 12 and 24 weeks after treatment, the% DHI of control group and DDD + high were higher than those of DDD group and DDD + gel group (P <0.05); T2 image signal of the DDD+High group and Control group is better than DDD group, DDD+GEL group, DDD+ Medium and DDD +Low group (P <0.05). Intradiscal injection of simvastatin can delay disc degeneration and has a dose effect. At 4 and 12 weeks after treatment, the water content of intervertebral disc in control group and DDD + high group in control group were higher than DDD group, DDD + gel group and DDD + low group(P <0.05). Conclution：we verified the therapeutic efficacy and dose effect of simvastatin sustained-release system in rabbit DLBP model. The optimal treatment concentration was further optimized based on the dose gradient.

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Are Modic type 2 disc changes associated with low-grade infections? A pilot study

Cited by 9 publications

References 20 publications

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

Evidence for infection in intervertebral disc degeneration: a systematic review

Efficacy And Dose Effect Of Intradiscal Injection Of Sustained-Release Simvastatin Hydrogel For Treatment Of Discogenic Low Back Pain In Rabbitsintradiscal

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Are Modic type 2 disc changes associated with low-grade infections? A pilot study

Cited by 9 publications

References 20 publications

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

Evidence for infection in intervertebral disc degeneration: a systematic review

Efficacy And Dose Effect Of Intradiscal Injection Of Sustained-Release Simvastatin Hydrogel For Treatment Of Discogenic Low Back Pain In Rabbitsintradiscal&nbsp;

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Efficacy And Dose Effect Of Intradiscal Injection Of Sustained-Release Simvastatin Hydrogel For Treatment Of Discogenic Low Back Pain In Rabbitsintradiscal