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Modic Changes and Disc Degeneration Caused by Inoculation of Propionibacterium acnes inside Intervertebral Discs of
Zhe Chen1, Yuehuan Zheng2, Ye Yuan3
1Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine, Shanghai Institute of Traumatology and Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Purpose:
To investigate whether P. acnes could induce disc degeneration and Modic changes when inoculated into the discs of rabbits.
Method:
A wild-type strain of P. acnes isolated from a patient associated with Modic change and disc degeneration was inoculated into the intervertebral discs of rabbits. Meanwhile, S. aureus was injected into the discs to establish a model of discitis as the comparison and a standard strain of P. acnes was inoculated as the control. MRI and histological change were observed.
Results:
Both the P. acnes-inoculated and S. aureus-inoculated rabbits showed hyperintense signals at endplates and hypointense signals at nucleus pulposus on T2WI. However, P. acnes only resulted in moderate disc degeneration and endplates rupture in histological examination, which was different from the pathological change of discitis caused by S. aureus. In addition, higher death rates (2/3 versus 0/5) were observed in S. aureus-inoculated rabbits.
Conclusion:
Compared to S. aureus, the pathological change caused by P. acnes would be considered as Modic-I change and disc degeneration rather than a discitis.
Insights
Propionibacterium acnes (P. acnes) can cause moderate disc degeneration and Modic changes in rabbits, distinct from the severe discitis induced by Staphylococcus aureus (S. aureus). This suggests P. acnes plays a role in spinal degeneration.
Area of Science:
- Orthopedics and Spine Research
- Microbiology and Infectious Diseases
- Radiology and Imaging
Background:
- Intervertebral disc degeneration and Modic changes are common spinal pathologies.
- The role of Propionibacterium acnes (P. acnes) in spinal degeneration is not fully understood.
- Distinguishing P. acnes-induced changes from bacterial discitis is clinically relevant.
Purpose of the Study:
- To determine if P. acnes can induce disc degeneration and Modic changes.
- To compare the pathological effects of P. acnes with Staphylococcus aureus (S. aureus) in a rabbit disc model.
Main Methods:
- Inoculation of a wild-type P. acnes strain into rabbit intervertebral discs.
- Comparison groups included S. aureus inoculation (to model discitis) and a control P. acnes strain.
- Magnetic resonance imaging (MRI) and histological analysis were used to assess changes.
Main Results:
- Both P. acnes and S. aureus groups showed characteristic MRI signal changes (T2WI hyperintense endplates, hypointense nucleus pulposus).
- P. acnes induced moderate disc degeneration and endplate rupture, differing from S. aureus-induced discitis.
- S. aureus inoculation resulted in significantly higher mortality rates compared to P. acnes.
Conclusions:
- P. acnes inoculation leads to Modic-I changes and disc degeneration, not acute discitis.
- The pathological findings of P. acnes differ significantly from those caused by S. aureus.
- P. acnes may be a contributing factor to non-infectious disc degeneration and Modic changes.
