Are viruses associated with disc herniation? A clinical case series

Abstract

Background: There is some limited evidence for the presence of viruses in herniated disc material including a previous case series that claimed to provide "unequivocal evidence of the presence of herpes virus DNA in intervertebral disc specimens of patients with lumbar disc herniation suggesting the potential role of herpes viruses as a contributing factor to the pathogenesis of degenerative disc disease". This study has not been replicated. The objective of our study was to determine if viruses were present in herniated disc fragments in participants with a prior history of back pain. Methods: We recruited fifteen participants with a history of prior low-back pain prior to undergoing disc herniation surgery in the lumbar spine. Harvested disc samples were subject to next generation sequencing for detection of both RNA and DNA viral pathogens. Additionally, samples were analysed by a broadly reactive PCR targeting herpesviral DNA. Ethics approval was granted by the

Frequency and characteristics of bacterial and viral low-grade infections of the intervertebral discs: a prospective, observational study

“…Studies on viral infections of the intervertebral disc are rare [10,37,38]. Alpantaki et al [10] reported a prevalence of positive PCR tests of 56.25% for HSV-1 and 37.5% for CMV in 16 patients.…”

“…Alpantaki et al [10] reported a prevalence of positive PCR tests of 56.25% for HSV-1 and 37.5% for CMV in 16 patients. Walker et al [38] investigated herniated disc tissue of 15 patients for herpesvirus DNA and did not detect any viral pathogens. In our sample, we found no evidence of any infection of the intervertebral discs by HSV-1, HSV-2, or CMV.…”

Correlation between gene expression and MRI STIR signals in patients with chronic low back pain and Modic changes indicates immune involvement

“…The other gene sets that were found significantly enriched among the differentially expressed genes across all STIR variables were pathways related to defense response to virus and mitochondrial metabolism. The involvement of viruses in the degeneration and herniation of discs have been suggested, but studies show inconclusive results 71 . However, the genes underlying the defence to virus pathway have rather broad immune and inflammatory functions also occurring without a viral trigger.…”