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Subclinical infection of the intervertebral disc after lumbar disc herniation surgery: a prospective cohort study

Abstract

Subclinical infection of the intervertebral disc after lumbar disc herniation surgery has been correlated to chronic low back pain and vertebral endplate changes. The most commonly reported agent is Propionibacterium acnes. However, the real incidence is unclear, as it has been reported in some series ranging from 3.7% to 46%. Recently, a systematic review concluded that there is a relationship between the P. acnes and endplate changes, but, there are so far no studies to verify whether the reported presence of that pathogen in the intervertebral discs is due to local infection or whether intraoperative contamination ocurred during the collection of the samples.Thus, the main objective of this study is to estimate the incidence of subclinical infection in patients with lumbar disc herniation treated surgically.To this end, a prospective cohort study will be conducted with a minimum of 95 patients between 18 and 65 years of age who have been submitted to surgery after clinical treatment failure. The extruded disc will be removed and cultured for bacterial identification. As controls, the ligamentum flavum and the multifidus muscle, taken respectively before and after removal of the herniated fragment will also be cultured. Patients will be followed-up for a year and MRI will be done at the end of the this period. (AU)

Articles published in Agência FAPESP Newsletter about the research grant:
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VEICULO: TITULO (DATA)
VEICULO: TITULO (DATA)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ASTUR, NELSON; MARTINS, DELIO E.; WAJCHENBERG, MARCELO; FERRETTI, MARIO; MENEZES, FERNANDO G.; DOI, ANDRE M.; ROSEMBERG, LAERCIO A.; SANTOS, DURVAL C. B.; IUTAKA, ALEXANDRE S.; RODRIGUES, LUCIANO M. R.; et al. Subclinical Propionibacterium acnes infection estimation in the intervertebral disc (SPInE-ID): protocol for a prospective cohort. BMJ OPEN, v. 7, n. 11, . (16/15830-7)