The role of infectious pathogens in etiopathogenesis of degenerative intervertebral disc diseases

Abstract

Objective. To analyze the presence of infectious pathogens in the intervertebral disc tissues as possible pathogenetic factor in the development of degenerative diseases of the spine. Material and Method. In 2017–2018, a prospective exploratory research was conducted, which included 64 patients with degenerative disease of the spine who met the following inclusion criteria: the presence of clinically and instrumentally proven hernias of the intervertebral discs in the lumbosacral spine, the absence of a history of surgical interventions on the spine, non-intake of antibacterial drugs for the year before surgery, and Modic I and/or II type changes on MRI. All patients underwent interventions with sampling of intervertebral disc material; a total of 80 discs were examined. The obtained materials were subjected to microbiological and histopathological studies. Results. Out of 64 patients, only 1 (1.6 %) revealed the presence of bacterial flora in the intervertebral disc tissue (Propionibacterium acnes strain). It can be assumed that the identified bacterial flora is the result of contamination. It is also possible that the infectious agent joined already during the development of degenerative disease of the spine. If the bacterial flora was a pathogenetic factor, then it can be assumed that the pathogenesis of the disease is polyetiological and includes the infectious process as a rare event. Conclusions. Given the high interest of specialists in the pathogenesis of degenerative diseases, it seems appropriate to conduct further studies in this direction using various laboratory diagnostic methods with high sensitivity and specificity.

Keywords

• spine
• disc herniation
• intervertebral disc herniation
• microdiscectomy
• degenerative disease
• bacteria
• infection