Skip to main content

Advertisement

Log in

Detection of bacterial DNA in painful degenerated spinal discs in patients without signs of clinical infection

  • Original Article
  • Disc (experimental)
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

A local inflammatory and potentially painful response, of which the ultimate cause is unknown, has been described in nervous tissues in contact with degenerated disc material in patients with low back and leg pain. With the rationale that a possible cause of such inflammation could be bacterial infection, we utilized PCR (polymerase chain reaction) amplification of the 16S rRNA (ribosomal RNA) gene followed by gene sequencing, to investigate whether bacterial DNA might be detected in the degenerative discs of 10 patients operated for disc herniation or post-discectomy syndrome. One patient with disc hernia harbored DNA homologous to Bacillus cereus, and in one patient suffering from post-discectomy syndrome, Citrobacter braaki/freundii DNA was detected. The finding demonstrates that 16S rRNA PCR can be a useful tool in search of bacterial DNA in degenerated discs, which in turn may be indicative of low-grade infection, manifesting itself only as pain rather than as clinical infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abrutyn E, Berlin J, Mossey J, Pitsakis P, Levison M, Kaye D (1996) Does treatment of asymptomatic bacteriuria in older ambulatory women reduce subsequent symptoms of urinary tract infection? J Am Geriatr Soc 3: 293–295

    Google Scholar 

  2. Aoki Y, Rydevik B, Kikuchi S, Olmarker K (2002) Local application of disc-related cytokines on spinal nerve roots. Spine 15: 1614–1617

    Article  Google Scholar 

  3. Bone RC (1991) The pathogenesis of sepsis. Ann Intern Med 6: 457–469

    Google Scholar 

  4. Brisby H, Byrod G, Olmarker K, Miller VM, Aoki Y, Rydevik B (2000) Nitric oxide as a mediator of nucleus pulposus-induced effects on spinal nerve roots. J Orthop Res 5: 815–820

    Article  Google Scholar 

  5. Brisby H, Olmarker K, Larsson K, Nutu M, Rydevik B (2002) Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica. Eur Spine J 1: 62–66

    Google Scholar 

  6. Brisby H, Balague F, Schafer D et al. (2002) Glycosphingolipid antibodies in serum in patients with sciatica. Spine 4: 380–386

    Article  Google Scholar 

  7. Byrod G, Olmarker K, Konno S, Larsson K, Takahashi K, Rydevik B (1995) A rapid transport route between the epidural space and the intraneural capillaries of the nerve roots. Spine 2: 138–143

    Google Scholar 

  8. Chia JK, Nakata MN (1996) intervertebral diskitis caused by Propionibacterium acnes: a report of four cases. Clin Infect Dis 3: 643–644

    Google Scholar 

  9. Cornefjord M, Olmarker K, Farley DB, Weinstein JN, Rydevik B (1995) Neuropeptide changes in compressed spinal nerve roots. Spine 6: 670–673

    Google Scholar 

  10. Cuchacovich R, Japa S, Huang WQ et al. (2002) Detection of bacterial DNA in Latin American patients with reactive arthritis by polymerase chain reaction and sequencing analysis. J Rheumatol 7: 1426–1429

    Google Scholar 

  11. Ford DK (1979) The clinical spectrum of Reiter’s syndrome and similar postenteric arthropathies. Clin Orthop 143: 59–65

    PubMed  Google Scholar 

  12. Garfin SR, Rydevik BL, Brown RA (1991) Compressive neuropathy of spinal nerve roots. A mechanical or biological problem? Spine 2: 162–166

    Google Scholar 

  13. Gronblad M, Habtemariam A, Vim J, Seitsalo S, Vanharanta H, Guyer RD (2003) Complement membrane attack complexes in pathologic disc tissues. Spine 2: 114–118

    Article  Google Scholar 

  14. Hedstrom SA (1996) Septic bone and joint infections. Curr Opin Rheumatol 4: 322–326

    Google Scholar 

  15. Hennequin C, Bouree P, Hiesse C, Dupont B, Charpentier B (1996) Spondylodiskitis due to Candida albicans: Report of two patients who were successfully treated with fluconazole and review of the literature. Clin Infect Dis 1: 176–178

    Google Scholar 

  16. Ho WZ, Evans DL, Douglas SD (2002) Substance P and human immunodeficiency virus infection: psychoneuroimmunology. CNS Spectrum 12: 867–874

    Google Scholar 

  17. Kahn MF (1995) Why the “SAPHO” syndrome? J Rheumatol 11: 2017–2019

    Google Scholar 

  18. Kayama S, Olmarker K, Larsson K, Sjogren-Jansson E, Lindahl A, Rydevik B (1998) Cultured, autologous nucleus pulposus cells induce functional changes in spinal nerve roots. Spine 20: 2155–2158

    Article  Google Scholar 

  19. Lamont JT (2002) Theodore E. Woodward Award. How bacterial enterotoxins work: insights from in vivo studies. Trans Am Clin Climatol Assoc: 167–180; discussion: 180–181

  20. Lidslot L, Olmarker K, Kayama S, Larsson K, Rydevik B (2000) Nucleus pulposus inhibits the axonal outgrowth of cultured dorsal root ganglion cells. Eur Spine J 1: 8–13

    Article  Google Scholar 

  21. Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 1: 193–199

    Google Scholar 

  22. Nachemson A, Vingård E, (2000) Assessment of patients with neck and back pain: a best-evidence synthesis. Lippincott Williams & Wilkins, Philadelphia, pp 189–235

    Google Scholar 

  23. Olmarker K, Larsson K (1998) Tumor necrosis factor alpha and nucleus-pulposus-induced nerve root injury. Spine 23: 2538–2544

    Article  PubMed  CAS  Google Scholar 

  24. Olmarker K, Rydevik B, Nordborg C (1993) Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots. Spine 11: 1425–1432

    Article  Google Scholar 

  25. Olmarker K, Blomquist J, Stromberg J, Nannmark U, Thomsen P, Rydevik B (1995) Inflammatogenic properties of nucleus pulposus. Spine 6: 665–669

    Article  Google Scholar 

  26. Olmarker K, Brisby H, Yabuki S, Nordborg C, Rydevik B (1997) The effects of normal, frozen, and hyaluronidase-digested nucleus pulposus on nerve root structure and function. Spine 5: 471–475; discussion 476

    Article  Google Scholar 

  27. Orhan I, Onur R, Ilhan N, Ardicoglu A (2001) Seminal plasma cytokine levels in the diagnosis of chronic pelvic pain syndrome. Int J Urol 9: 495–499

    Article  Google Scholar 

  28. Rand N, Reichert F, Floman Y, Rotshenker S (1997) Murine nucleus pulposus-derived cells secrete interleukins-1-beta, -6, and -10 and granulocyte-macrophage colony-stimulating factor in cell culture. Spine 22: 2598–2601; discussion:2602

    Article  PubMed  CAS  Google Scholar 

  29. Rask MR (1977) Low back pain due to neisseria prostatitis: report of three cases. Clin Orthop 127: 120–122

    PubMed  Google Scholar 

  30. Robinson SC (1979) Bacillus cereus septic arthritis following arthrography. Clin Orthop 145: 237–238

    PubMed  Google Scholar 

  31. Skouen JS, Brisby H, Otani K, Olmarker K, Rosengren L, Rydevik B (1999) Protein markers in cerebrospinal fluid in experimental nerve root injury. A study of slow-onset chronic compression effects or the biochemical effects of nucleus pulposus on sacral nerve roots. Spine 21: 2195–2200

    Article  Google Scholar 

  32. Stirling A, Worthington T, Rafiq M, Lambert PA, Elliott TS (2001) Association between sciatica and Propioni-bacterium acnes. Lancet 9273: 2024–2025

    Article  Google Scholar 

  33. Stricker T, Frohlich S, Nadal D (1998) Osteomyelitis and septic arthritis due to Citrobacter freundii and Haemophilus influenzae type b. J Paediatr Child Health 1: 90–91

    Article  Google Scholar 

  34. Trotha R, Hanck T, Konig W, Konig B (2001) Rapid ribosequencing — an effective diagnostic tool for detecting microbial infection. Infection 1: 12–16

    Article  Google Scholar 

  35. Wirtz DC, Genius I, Wildberger JE, Adam G, Zilkens KW, Niethard FU (2000) Diagnostic and therapeutic management of lumbar and thoracic spondy-lodiscitis — an evaluation of 59 cases. Arch Orthop Trauma Surg 5–6: 245–251

    Article  Google Scholar 

  36. Youssef PP, York JR (1994) Septic arthritis: a second decade of experience. Aust N Z J Med 3: 307–311

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter Fritzell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fritzell, P., Bergström, T. & Welinder-Olsson, C. Detection of bacterial DNA in painful degenerated spinal discs in patients without signs of clinical infection. Eur Spine J 13, 702–706 (2004). https://doi.org/10.1007/s00586-004-0719-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-004-0719-z

Keywords

Navigation