Disc Degeneration
Conditions
Keywords
low-grade infection, intervertebral disc, spine, cutibacterium acnes, culture, herpes simplex, modic changes, CRP, histopathology, microbiology, oswestry disability index, neck disability index
Brief summary
The purpose of this prospective, observational study was to evaluate frequency and characteristics of low-grade infections of the intervertebral discs in an unselected real-life patient population undergoing surgery for degenerative pathologies of the spine.
Detailed description
Low-grade infection of the intervertebral discs, causing disc degeneration and consecutive pain and disability is reported in literature. Microorganisms are also held responsible for Modic Changes of the vertebral bodies. Patients underwent surgery for degenerative pathology of the spine independent of this study. After being informed about this study, all patients giving written informed consent who met eligibility requirements were included. Treatment of the patients was independent of this study. Intraoperative removed disc tissue was examined using microbiological culture, viral polymerase chain reaction (PCR), and histopathological analysis. Other used data were demographic data (Gender, age), Modic Changes on MRI, preoperative Oswestry Disability Index (ODI), preoperative Neck Disability Index (NDI), and preoperative C-reactive protein (CRP). Frequency of positive microbiological culture findings, viral PCR, and inflammation signs in histopathological analysis was described, and statistical analysis was performed to identify if any of the above mentioned parameters influences the frequency of positive microbiological culture and Modic Changes significant.
Interventions
DIAGNOSTIC_TESTMicrobiological culture, viral PCR, histopathological analysis
Intervertebral disc tissue was sent to the laboratory for further analysis: Microbiological culture: Detection of bacterial growth Viral PCR: Detection of Herpes-Simplex-Type 1 virus, Herpes-Simplex-Type 2 virus, Cytomegalovirus Histopathological analysis: Inflammation signs of disc tissue
Sponsors
Kepler University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Spine surgery including discectomy due to degenerative diseases * Availability of removed disc tissue for further analysis
Exclusion criteria
* Signs of spondylodiscitis (clinical signs, inflammation parameters, radiological) * Suspected or known tumor disease * Traumatic fractures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bacterial growth | 1 week (Time from surgery until final result of microbiological culture was available) | Number of intervertebral discs with at least one positive microbiological culture result |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HSV-2 | 1 week (Time from surgery until final result of PCR was available) | Number of intervertebral discs with at least one positive result for Herpes-Simplex-Virus type 2 |
| CMV | 1 week (Time from surgery until final result of PCR was available) | Number of intervertebral discs with at least one positive result for Cytomegalovirus |
| MC 1 | Measured on preoperative MRI (maximum 3 months old) | Positive Modic Change type 1 in the operated segment |
| MC 2 | Measured on preoperative MRI (maximum 3 months old) | Positive Modic Change type 2 in the operated segment |
| HSV-1 | 1 week (Time from surgery until final result of PCR was available) | Number of intervertebral discs with at least one positive result for Herpes-Simplex-Virus type 1 |
| ODI | Measured preoperative at hospital admission, i.e. 1-3 days before operation | Oswestry Disability Index, measured only in case of lumbar spine surgery |
| NDI | Measured preoperative at hospital admission, i.e. 1-3 days before operation | Neck Disability Index, measured only in case of cervical spine surgery |
| CRP | Measured preoperative at hospital admission, i.e. 1-3 days before operation | C-reactive protein in mg/dl, measured as blood sample |
| Pathology | 1 week (Time from surgery until final result of histopathological analyzsis was available) | Positive inflammation signs in histopathological analysis. Analyzed for each collected intervertebral disc |
| MC 3 | Measured on preoperative MRI (maximum 3 months old) | Positive Modic Change type 2 in the operated segment |
Countries
Austria
Outcome results
None listed