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Bacteria :
Bacteria : back pain, leg pain and Modic sign—a surgical multicentre comparative study
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- Fritzell, Peter (författare)
- Futurum Academy, Länssjukhuset Ryhov, Jönköping, Sweden,Futurum Acad, Lanssjukhuset Ryhov, S-55185 Jonkoping, Sweden
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- Welinder-Olsson, Christina (författare)
- Sahlgrenska University Hospital, Göteborg, Sweden,Sahlgrens Univ Hosp, S-41346 Gothenburg, Sweden
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- Jönsson, Bodil (författare)
- Sahlgrenska University Hospital, Göteborg, Sweden,Sahlgrens Univ Hosp, S-41346 Gothenburg, Sweden
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- Melhus, Åsa (författare)
- Uppsala universitet,Infektionsmedicin,Uppsala Univ Hosp, Sweden
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- Andersson, Siv (författare)
- Uppsala universitet,Molekylär evolution,Uppsala Univ, Sweden
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- Bergström, Tomas, 1950 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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- Tropp, Hans (författare)
- Linköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping
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- Gerdhem, Paul (författare)
- Karolinska Institutet,Karolinska Univ Hosp, Sweden
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- Hägg, Olle (författare)
- Spine Center Göteborg, Västra Frölunda, Sweden,Spine Ctr Goteborg, S-42130 Vastra Frolunda, Sweden
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- Laestander, Hans (författare)
- Spine Center Göteborg, Västra Frölunda, Sweden,Spine Ctr Goteborg, S-42130 Vastra Frolunda, Sweden
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- Knutsson, Björn (författare)
- Sundsvall Hospital, Sundsvall, Sweden,Sundsvall Hosp, S-85786 Sundsvall, Sweden
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- Lundin, Anders (författare)
- Örebro University Hospital, Örebro, Sweden,Orebro Univ Hosp, S-70185 Orebro, Sweden
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- Ekman, Per (författare)
- Karolinska Institutet,Soder Sjukhuset, Sweden
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- Rydman, Eric (författare)
- Södersjukhuset, Stockholm, Sweden,Soder Sjukhuset, S-11883 Stockholm, Sweden
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- Skorpil, Mikael (författare)
- Karolinska University Hospital, Stockholm, Sweden,Karolinska Univ Hosp, S-17164 Stockholm, Sweden
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(creator_code:org_t)
- 2019-10-01
- 2019
- Engelska.
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 28:12, s. 2981-2989
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Abstract
Ämnesord
Stäng
- Purpose: To compare bacterial findings in pain-generating degenerated discs in adults operated on for lumbar disc herniation (LDH), and mostly also suffering from low back pain (LBP), with findings in adolescent patients with non-degenerated non-pain-generating discs operated on for scoliosis, and to evaluate associations with Modic signs on magnetic resonance imaging (MRI). Cutibacterium acnes (Propionibacterium acnes) has been found in painful degenerated discs, why it has been suggested treating patients with LDH/LBP with antibiotics. As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence.Methods: Between 2015 and 2017, 40 adults with LDH/LBP (median age 43, IQR 33–49) and 20 control patients with scoliosis (median age 17, IQR 15–20) underwent surgery at seven Swedish hospitals. Samples were cultured from skin, surgical wound, discs and vertebrae. Genetic relatedness of C. acnes isolates was investigated using single-nucleotide polymorphism analysis. DNA samples collected from discs/vertebrae were analysed using 16S rRNA-based PCR sequencing. MRI findings were assessed for Modic changes.Results: No bacterial growth was found in 6/40 (15%) LDH patients, compared with 3/20 (15%) scoliosis patients. Most positive samples in both groups were isolated from the skin and then from subcutis or deep within the wound. Of the four disc and vertebral samples from each of the 60 patients, 235/240 (98%) were DNA negative by bacterial PCR. A single species, C. acnes, was found exclusively in the disc/vertebra from one patient in each group. In the LDH group, 29/40 (72%) patients had at least one sample with growth of C. acnes, compared to 14/20 (70%) in the scoliosis group. Bacterial findings and Modic changes were not associated.Conclusions: Cutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be seriously questioned.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Culturing
- Cutibacterium acnes
- DNA analyses
- Low back pain
- Lumbar disc herniation
- Magnetic resonance imaging (MRI)
- Multicentre clinical study
- RNA 16S
- adult
- Article
- bacterial growth
- bacterium isolation
- clinical article
- comparative study
- female
- human
- lumbar disk hernia
- male
- modic sign
- multicenter study
- nuclear magnetic resonance imaging
- observational study
- polymerase chain reaction
- priority journal
- Propionibacterium acnes
- prospective study
- scoliosis
- single nucleotide polymorphism
- skin culture
- surgical wound
- symptomatology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Fritzell, Peter
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Welinder-Olsson, ...
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Jönsson, Bodil
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Melhus, Åsa
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Andersson, Siv
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Bergström, Tomas ...
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Tropp, Hans
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Gerdhem, Paul
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Hägg, Olle
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Laestander, Hans
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Knutsson, Björn
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Lundin, Anders
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Ekman, Per
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Rydman, Eric
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Skorpil, Mikael
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Ortopedi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Infektionsmedici ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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European spine j ...
- Av lärosätet
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Jönköping University
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Umeå universitet
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Uppsala universitet
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Karolinska Institutet
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Linköpings universitet
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Göteborgs universitet