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Overview: the role of Propionibacterium acnes in nonpyogenic intervertebral discs

Zhe Chen1,2, Peng Cao3,4, Zezhu Zhou1,2

  • 1Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.

International Orthopaedics
|January 29, 2016
PubMed

Insights

Propionibacterium acnes (P. acnes) commonly colonizes intervertebral discs, potentially causing low back pain and sciatica. Antibiotic treatment suggests P. acnes plays a role in these conditions.

Area of Science:

  • Microbiology
  • Orthopedics
  • Infectious Diseases

Background:

  • Propionibacterium acnes (P. acnes) is an opportunistic anaerobic Gram-positive bacterium.
  • P. acnes is implicated in bone and joint infections, discitis, and spondylodiscitis.
  • Evidence suggests P. acnes can asymptomatically colonize intervertebral discs.

Purpose of the Study:

  • To summarize the prevalence of P. acnes in nonpyogenic intervertebral discs.
  • To explore the potential role of P. acnes in causing sciatica, Modic changes, and low back pain.
  • To highlight the limited understanding of P. acnes's access and pathogenic mechanisms in latent disc infections.

Main Methods:

  • Literature review and epidemiological data analysis.
  • Examination of clinical observations regarding antibiotic therapy outcomes.
  • Synthesis of existing hypotheses on P. acnes pathogenesis in intervertebral discs.

Main Results:

  • P. acnes colonization prevalence in intervertebral discs ranges from 13% to 44%.
  • P. acnes is associated with sciatica, Modic changes, and nonspecific low back pain.
  • Antibiotic therapy provides relief, indicating P. acnes's pathological role.

Conclusions:

  • P. acnes is a significant colonizer of intervertebral discs with a potential role in discogenic pain.
  • Further research is needed on P. acnes's pathogenesis, diagnosis, and treatment strategies for disc infections.
  • This paper consolidates current knowledge on P. acnes in nonpyogenic intervertebral discs.
Keywords:
Modic changesNonpyogenic intervertebral discsNonspecific low back painP. acnesSciatica

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