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Modic changes in the adjacent vertebrae due to disc material infection with Propionibacterium acnes in patients with
Javad Aghazadeh1, Firooz Salehpour1, Ehsan Ziaeii1
1Department of Neurosurgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Introduction:
Modic changes (MCs) in vertebral bones are induced by two mechanisms of mechanical factors and infection. As Propionibacterium acnes (P. acnes) have been reported to be associated with LBP. The aim of this study is to evaluate the MCs in patients with disc herniation and positive for P. acnes.
Methods And Material:
A total of 120 patients with disc herniation surgery were enrolled into the study. The samples were excised during discectomy and then cultured in both anaerobic and aerobic incubations. Gram staining was employed for investigation of all colonies. The cultured P. acnes were detected by 16S rRNA-based polymerase chain reaction (PCR). MCs of baseline MRI were evaluated.
Results:
In this study, 120 subjects (69 male and 51 female) with mean age of 43.15 ± 12.62 years were investigated. Sixty disc samples and eight muscle samples were positive for microorganisms. Moreover, 16S rDNA gene was identified in 46 (38.3%) disc samples. Moreover, 36/46 patients with P. acnes in their sample had MCs.
Conclusion:
According to the results and presence of 36/46 MCs in patients with lumbar disc herniation, positive for P. acnes suggests that P. acnes can lead to edema on the vertebrae endplates near to infected area.
Insights
Propionibacterium acnes (P. acnes) infection in patients with lumbar disc herniation is linked to Modic changes (MCs). This suggests P. acnes may cause vertebral endplate edema in infected areas.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Modic changes (MCs) are vertebral bone alterations linked to mechanical stress and infection.
- Propionibacterium acnes (P. acnes) has been implicated in low back pain (LBP).
Purpose of the Study:
- To investigate the association between Modic changes (MCs) and P. acnes infection in patients with lumbar disc herniation.
Main Methods:
- 120 patients undergoing discectomy for disc herniation were studied.
- Bacterial cultures and 16S rRNA-based PCR were used to detect P. acnes in disc samples.
- Baseline MRI was used to evaluate Modic changes.
Main Results:
- P. acnes was detected in 38.3% (46/120) of disc samples.
- Of the patients with P. acnes, 78.3% (36/46) exhibited Modic changes.
Conclusions:
- The presence of Modic changes in P. acnes-positive patients suggests P. acnes infection can induce vertebral endplate edema near infected sites.
