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.
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.
Study Type
OBSERVATIONAL
Enrollment
392
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
Department of Neurosurgery, Kepler University Hospital
Linz, Upper Austria, Austria
Bacterial growth
Number of intervertebral discs with at least one positive microbiological culture result
Time frame: 1 week (Time from surgery until final result of microbiological culture was available)
HSV-1
Number of intervertebral discs with at least one positive result for Herpes-Simplex-Virus type 1
Time frame: 1 week (Time from surgery until final result of PCR was available)
HSV-2
Number of intervertebral discs with at least one positive result for Herpes-Simplex-Virus type 2
Time frame: 1 week (Time from surgery until final result of PCR was available)
CMV
Number of intervertebral discs with at least one positive result for Cytomegalovirus
Time frame: 1 week (Time from surgery until final result of PCR was available)
MC 1
Positive Modic Change type 1 in the operated segment
Time frame: Measured on preoperative MRI (maximum 3 months old)
MC 2
Positive Modic Change type 2 in the operated segment
Time frame: Measured on preoperative MRI (maximum 3 months old)
MC 3
Positive Modic Change type 2 in the operated segment
Time frame: Measured on preoperative MRI (maximum 3 months old)
ODI
Oswestry Disability Index, measured only in case of lumbar spine surgery
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Time frame: Measured preoperative at hospital admission, i.e. 1-3 days before operation
NDI
Neck Disability Index, measured only in case of cervical spine surgery
Time frame: Measured preoperative at hospital admission, i.e. 1-3 days before operation
CRP
C-reactive protein in mg/dl, measured as blood sample
Time frame: Measured preoperative at hospital admission, i.e. 1-3 days before operation
Pathology
Positive inflammation signs in histopathological analysis. Analyzed for each collected intervertebral disc
Time frame: 1 week (Time from surgery until final result of histopathological analyzsis was available)