Are Infections the reason for Disk Degeneration?

Are Infections the reason for Disk Degeneration?

Are Infections the reason for Disk Degeneration?

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Dr. Ganko et al Published an intriguing article called “Can Baterial Infection by Low Virulent Organisms Be a Plausible Cause for Symptomatic Disk Degeneration?: A Systematic Review” in the May 15, 2015 issue of Spine.

To summarize the paper,  prior studies on the prevalence of infections in disk material were pooled together to do a so called meta-analysis.   9 papers,  with a pooled population of 602 patients were analysed.  Only one of the papers had patients given prophylactic antibiotics before sampling the disk material.

The data showed that approximately 36% of the samples had evidence of a low grade bacterial infection.  The most common organism was Propionibacterium acnes,  a bacteria found commonly on the skin.  It is a low virulence bacteria.  This low virulence and destruction potential may be why it may be found in the disks without evidence of a full blown disk infection  (discitis).

As most of the samples were obtained in patients not given pre-operative antibiotics,  it may be why we do not see this high prevalence in patients in the US,  as pre-op antibiotics is fairly common.

The question remains, what is the reason for this high prevalence of infection?  As the patients who underwent the surgery had disk pathology,  back pain,  and/or sciatica,  is there a relationship with a low grade bacterial infection and the presence of the disk pathology?  Does the low grade bacterial infection make the disk more susceptible to developing a symptomatic disk pathology?

The authors appropriately question the validity of the results,  and suggest more studies to try to answer these questions.   Still,  papers like these point out that we still do not fully understand the nature of disk degeneration,  the causes of disk herniations,  and the cascade of events that may contribute to the development of these disk findings.

The paper  does present another potential factor for why people develop disk degeneration.

Citations

  • Ganko R, Rao PJ, Phan K, Mobbs RJ. Can bacterial infection by low virulent organisms be a plausible cause for symptomatic disc degeneration? A systematic review. Spine (Phila Pa 1976). 2015 May 15;40(10):E587-92. PubMed PMID: 25955094

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Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

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The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

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September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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