Abstract
Objective. To analyze the frequency and types of microbial infection of the intervertebral disc in degenerative diseases of the spine and to compare the obtained data with the results of pathohistological, X-ray and MRI studies to determine tactical approaches to surgical interventions on the spine. Material and Methods . The study was performed in 97 patients who underwent surgical treatment for degenerative spine disease. Discectomy was performed in 48 patients, and single- or multilevel decompression and stabilization in 49. Microbiological (117 samples) and pathohistological (73 samples) studies of disc material, clinical and neurological examinations of patients, and evaluation of X-ray and MRI findings were carried out. Results. Bacterial culture of the disc material was positive in 27.0 % of cases of discectomy and in 30.6 % of decompression and stabilization cases. The most frequent pathogens were obligate-anaerobic gram-positive bacteria (P. acnes) and epidermal staphylococci (S. epidermidis), in 42.8 % and 31.4 % of cases, respectively. The mixed microflora was detected in 20.0 % of observations. Pathohistological study revealed the signs of chronic inflammation in 42.8 % of patients with disc infection and in 5.7 % of patients without infection. There was no significant correlation between infection of the disc and chronic diseases, clinical manifestations, sequester, Modic type 1 changes in MRI, segment instability, and changes in CT. Conclusion . The probability of disc infection is higher in repeated operations and in degenerative lesion of discs with pain and radicular syndrome. The most reliable mechanism of intervertebral disc infection is the theory of microbial biofilms.
Highlights
There was no significant correlation between infection of the disc and chronic diseases, clinical manifestations, sequester, Modic type 1 changes in MRI, segment instability, and changes in CT
Relationship between annular tear and presence of Propionibacterium acnes in lumbar intervertebral disc
Summary
To analyze the frequency and types of microbial infection of the intervertebral disc in degenerative diseases of the spine and to compare the obtained data with the results of pathohistological, X-ray and MRI studies to determine tactical approaches to surgical interventions on the spine. Роль инфекционно-воспалительного фактора в дегенерации межпозвонковых дисков // Хирургия позвоночника. O.G. Prudnikova et al The role of infection and inflammation in intervertebral disc degeneration. Роль бактерий в этиопатогенезе, клинических проявлениях и течении послеоперационного периода при оперативных вмешательствах на позвоночнике у больных с дегенеративным заболеванием МПД требует дальнейшего изучения, что и явилось побудительным моментом для нашей работы. Цель исследования – анализ частоты и видов микробного инфицирования МПД, сопоставление полученных данных с клинико-неврологическим статусом пациентов, результатами патогистологических, рентгенологических исследований и МРТ для определения тактики при оперативных вмешательствах на позвоночнике.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.