Hyperbaric oxygen treatment: A complementary treatment modality of Modic changes?

Area of Science:

• Spinal Imaging and Degenerative Disc Disease
• Infectious Disease of the Spine
• Hyperbaric Medicine

Background:

• Modic changes (MCs) are associated with spinal degeneration and chronic low back pain.
• Type 1 MCs are linked to low-virulent anaerobic infections, often Propionibacterium acnes, following disc herniation.
• Current treatments for Type 1 MCs and associated pain are often ineffective.

Purpose of the Study:

• To explore the potential benefits of hyperbaric oxygen therapy (HBOT) in treating Type 1 MCs and associated chronic low back pain.
• To investigate HBOT's role as a primary or adjuvant therapy for suspected low-virulent disc infections.

Main Methods:

• Review of recent studies on antibiotic treatment for Type 1 MCs.
• Analysis of the proposed mechanisms of HBOT in combating anaerobic disc infections.
• Evaluation of HBOT's potential anti-inflammatory and anti-biofilm effects.

Main Results:

• Systemic antibiotic treatment has shown promising results for chronic low back pain with Type 1 MCs.
• HBOT may exert direct antimicrobial effects via reactive oxygen species (ROS) and create an unfavorable environment for anaerobic bacteria.
• HBOT could reduce inflammation and enhance antibiotic efficacy against Propionibacterium acnes.

Conclusions:

• HBOT offers potential advantages in treating low-virulent anaerobic disc infections associated with Type 1 MCs.
• HBOT may accelerate the resolution of Type 1 MCs and alleviate associated chronic low back pain.
• Combined HBOT and antibiotic therapy could significantly improve patient outcomes and quality of life.