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Is the discopathy associated with Modic changes an infectious process? Results from a prospective monocenter study

Salim Ahmed-Yahia1, Jean-Winoc Decousser2,3, Charles Henri Flouzat-Lachaniette4

  • 1Rheumatology Departement, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.

Plos One
|August 16, 2019
PubMed
Abstract

Insights

This study investigated Cutibacterium acnes (CA) in Modic 1 discopathy. Results suggest CA presence in disc samples is likely due to contamination during surgery, not an infectious cause of Modic 1 changes.

Area of Science:

  • Spine Surgery
  • Microbiology
  • Infectious Diseases

Background:

  • The role of Cutibacterium acnes (CA) in Modic 1 discopathy remains debated.
  • Investigating a potential local infectious origin for this condition is crucial.

Purpose of the Study:

  • To determine the association between CA and Modic 1 discopathy in patients experiencing low back pain.
  • To compare CA prevalence in intervertebral disc (IVD) samples from patients with and without Modic changes.

Main Methods:

  • Compared bacterial prevalence in IVD samples from anterior and posterior surgical approaches.
  • Utilized conventional microbial cultures, 16S rRNA gene detection, and CA-specific PCR.
  • Analyzed 77 IVD samples from 45 patients with varying Modic changes.

Main Results:

  • 15.6% of disc samples were culture-positive for bacteria.
  • CA was found in 8.6% of anterior approach samples and 26.3% of posterior approach samples (p=0.046).
  • No significant difference in CA prevalence between Modic and non-Modic groups; molecular methods showed lower CA prevalence.

Conclusions:

  • Higher CA prevalence in posterior approach samples suggests surgical contamination.
  • The study does not support CA as a cause of local infection in Modic 1 discopathy.

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