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Related Experiment Video

Updated: May 12, 2026

Ovine Lumbar Intervertebral Disc Degeneration Model Utilizing a Lateral Retroperitoneal Drill Bit Injury
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Bacterial identification in herniated intervertebral discs: a prospective cohort study.

Nelson Astur1, Delio Eulalio Martins1, Michel Kanas1

  • 1Department of Orthopaedics and Traumatology, Hospital Israelita Albert Einstein, São Paulo, Brazil.

The Spine Journal : Official Journal of the North American Spine Society
|June 6, 2024
PubMed
Summary

Cutibacterium acnes (C. acnes) infection is not a significant factor in lumbar disc herniation or Modic changes post-microdiscectomy. Bacterial presence in discs was low, with no link to clinical outcomes.

Keywords:
BacteriaCutibacterium acnesInfectionsIntervertebral Disc DegenerationIntervertebral Disc DisplacementSpineSurgery

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Area of Science:

  • Spinal surgery
  • Infectious disease
  • Radiology

Background:

  • Cutibacterium acnes (C. acnes) presence in intervertebral disc cultures suggests a role in inflammatory conditions causing Modic changes on MRI.
  • Investigating C. acnes prevalence is crucial for understanding its potential impact on spinal health.

Purpose of the Study:

  • To determine the prevalence of C. acnes in lumbar disc herniation samples.
  • To identify prognostic factors and the relationship between Modic changes and infection one year post-microdiscectomy.

Main Methods:

  • Prospective cohort study involving 112 patients undergoing lumbar microdiscectomy.
  • Disc, muscle, and ligament samples were cultured; a subset underwent next-generation sequencing (NGS).
  • Clinical outcomes, Modic changes, and potential confounding factors were assessed pre- and post-surgery.

Main Results:

  • Cultures revealed low bacterial presence in discs (6.3%) and ligaments (2.7%), with C. acnes found in 2 disc samples.
  • No significant differences in Modic alterations or clinical outcomes (pain, function) were observed between infected and non-infected patients one year post-surgery.
  • NGS analysis did not detect C. acnes in any samples.

Conclusions:

  • Infective bacterial presence in herniated discs is uncommon (<2%), and C. acnes was not detected via disc microbiome analysis.
  • No significant association was found between positive tissue infection and clinical prognostic factors after microdiscectomy.
  • The study suggests C. acnes is unlikely to be a primary driver of Modic changes or poor outcomes in this patient group.