Abstract：
METHODS: Monocentric, prospective, observational study.
OBJECTIVE: The clinical relevance of bacterial colonization of intervertebral discs is controversial. This study aimed to determine a possible relationship between bacterial and viral colonization and low-grade infection of the discs.
METHODS: We investigated 447 disc samples from 392 patients. Microbiological culture was used to examine the samples for bacterial growth, polymerase chain reaction (PCR) was used for detection of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and Cytomegalovirus (CMV), and histopathological analysis was used to detect signs of inflammation. The results were compared between subgroups organized according to gender, age, location of the samples, surgical approach, preoperative C-reactive protein (CRP), preoperative and 6 months postoperative Oswestry Disability Index (ODI) and Neck Disability Index (NDI), and Modic changes (MC) of the corresponding endplates. Also, we assessed the occurrence of postoperative infections within 6 months.
RESULTS: Microbiological culture was positive in 38.78% of the analyzed intervertebral discs. Altogether, 180 bacteria were isolated. Coagulase-negative staphylococci (CONS) (23.41%) and Cutibacterium acnes (18.05%) were the most frequently detected microorganisms. None of HSV-1, HSV-2, or CMV were detected. Male patients (p = 0.00036) and cervical segments (p = 0.00001) showed higher rates of positive culture results. Ventral surgical approaches ( p < 0.001) and Type 2 MC (p = 0.0127) were significantly associated with a positive microbiological result ( p< 0.001). Neither pre- nor postoperative ODI and NDI are associated with positive culture results. In 4 (1.02%) patients, postoperative spondylodiscitis occurred.
CONCLUSIONS: With 447 segments from 392 patients, we present one of the largest studies to date. While disc degeneration caused by HSV-1, HSV-2, and CMV seems unlikely, we found positive microbiological culture results in 38.78% of all discs. The role of local skin flora and sample contamination should be the focus of further investigations.
METHODS: III.
BACKGROUND: The study was registered at ClinicalTrials.gov (ID: NCT04712487, https://www.
RESULTS: gov/ct2/show/study/NCT04712487 ).
OBJECTIVE: The clinical relevance of bacterial colonization of intervertebral discs is controversial. This study aimed to determine a possible relationship between bacterial and viral colonization and low-grade infection of the discs.
METHODS: We investigated 447 disc samples from 392 patients. Microbiological culture was used to examine the samples for bacterial growth, polymerase chain reaction (PCR) was used for detection of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and Cytomegalovirus (CMV), and histopathological analysis was used to detect signs of inflammation. The results were compared between subgroups organized according to gender, age, location of the samples, surgical approach, preoperative C-reactive protein (CRP), preoperative and 6 months postoperative Oswestry Disability Index (ODI) and Neck Disability Index (NDI), and Modic changes (MC) of the corresponding endplates. Also, we assessed the occurrence of postoperative infections within 6 months.
RESULTS: Microbiological culture was positive in 38.78% of the analyzed intervertebral discs. Altogether, 180 bacteria were isolated. Coagulase-negative staphylococci (CONS) (23.41%) and Cutibacterium acnes (18.05%) were the most frequently detected microorganisms. None of HSV-1, HSV-2, or CMV were detected. Male patients (p = 0.00036) and cervical segments (p = 0.00001) showed higher rates of positive culture results. Ventral surgical approaches ( p < 0.001) and Type 2 MC (p = 0.0127) were significantly associated with a positive microbiological result ( p< 0.001). Neither pre- nor postoperative ODI and NDI are associated with positive culture results. In 4 (1.02%) patients, postoperative spondylodiscitis occurred.
CONCLUSIONS: With 447 segments from 392 patients, we present one of the largest studies to date. While disc degeneration caused by HSV-1, HSV-2, and CMV seems unlikely, we found positive microbiological culture results in 38.78% of all discs. The role of local skin flora and sample contamination should be the focus of further investigations.
METHODS: III.
BACKGROUND: The study was registered at ClinicalTrials.gov (ID: NCT04712487, https://www.
RESULTS: gov/ct2/show/study/NCT04712487 ).
摘要：
方法：单中心，prospective,观察性研究。
目的：椎间盘细菌定植的临床相关性存在争议。这项研究旨在确定细菌和病毒定植与椎间盘低度感染之间的可能关系。
方法：我们调查了392例患者的447个椎间盘样本。微生物培养用于检查样品的细菌生长，聚合酶链反应（PCR）用于检测1型和2型单纯疱疹病毒（HSV-1，HSV-2）和巨细胞病毒（CMV），组织病理学分析用于检测炎症迹象。结果在按性别组织的亚组之间进行比较，年龄,样品的位置，手术方法,术前C反应蛋白(CRP),术前和术后6个月Oswestry残疾指数（ODI）和颈部残疾指数（NDI），和相应端板的修改变化(MC)。此外，我们评估了术后6个月内感染的发生情况.
结果：在38.78%的被分析椎间盘中微生物培养阳性。总之,分离出180个细菌。凝固酶阴性葡萄球菌（CONS）（23.41％）和痤疮杆菌（18.05％）是最常见的微生物。未检测到HSV-1、HSV-2或CMV。男性患者（p=0.00036）和宫颈节段（p=0.00001）显示出更高的阳性培养结果。腹侧手术入路（p<0.001）和2型MC（p=0.0127）与微生物阳性结果显着相关（p<0.001）。术前或术后ODI和NDI均与阳性培养结果无关。在4例（1.02%）患者中，术后发生脊椎盘炎。
结论：392例患者的447段，我们提出了迄今为止最大的研究之一。虽然由HSV-1，HSV-2和CMV引起的椎间盘退变似乎不太可能，我们发现38.78%的光盘微生物培养结果为阳性。局部皮肤菌群和样品污染的作用应成为进一步研究的重点。
方法：III.
背景：该研究已在ClinicalTrials.gov注册（ID：NCT04712487，https：//www。
结果：gov/ct2/show/study/NCT04712487）。
目的：椎间盘细菌定植的临床相关性存在争议。这项研究旨在确定细菌和病毒定植与椎间盘低度感染之间的可能关系。
方法：我们调查了392例患者的447个椎间盘样本。微生物培养用于检查样品的细菌生长，聚合酶链反应（PCR）用于检测1型和2型单纯疱疹病毒（HSV-1，HSV-2）和巨细胞病毒（CMV），组织病理学分析用于检测炎症迹象。结果在按性别组织的亚组之间进行比较，年龄,样品的位置，手术方法,术前C反应蛋白(CRP),术前和术后6个月Oswestry残疾指数（ODI）和颈部残疾指数（NDI），和相应端板的修改变化(MC)。此外，我们评估了术后6个月内感染的发生情况.
结果：在38.78%的被分析椎间盘中微生物培养阳性。总之,分离出180个细菌。凝固酶阴性葡萄球菌（CONS）（23.41％）和痤疮杆菌（18.05％）是最常见的微生物。未检测到HSV-1、HSV-2或CMV。男性患者（p=0.00036）和宫颈节段（p=0.00001）显示出更高的阳性培养结果。腹侧手术入路（p<0.001）和2型MC（p=0.0127）与微生物阳性结果显着相关（p<0.001）。术前或术后ODI和NDI均与阳性培养结果无关。在4例（1.02%）患者中，术后发生脊椎盘炎。
结论：392例患者的447段，我们提出了迄今为止最大的研究之一。虽然由HSV-1，HSV-2和CMV引起的椎间盘退变似乎不太可能，我们发现38.78%的光盘微生物培养结果为阳性。局部皮肤菌群和样品污染的作用应成为进一步研究的重点。
方法：III.
背景：该研究已在ClinicalTrials.gov注册（ID：NCT04712487，https：//www。
结果：gov/ct2/show/study/NCT04712487）。
