Would Cutibacterium acnes Be the Villain for the Chronicity of Low Back Pain in Degenerative Disc Disease? Preliminary Results of an Analytical Cohort
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Microbiological Analyses
3.2. Preoperative Features
3.3. Operative Features
3.4. Postoperative Features
3.5. Modic Changes
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Inclusion | Exclusion |
---|---|
Age between 18 and 65 years | History of previous lumbar spine surgery |
LBP a lasting more than 3 months | Chemotherapy or pulse therapy with corticoids |
MRI b performed less than 6 months before surgery | History of spinal infection |
Failure of conservative treatment for at least 6 weeks | Previous intradiscal therapies |
Data | Moment of Collection | |||
---|---|---|---|---|
Enrollment. | 1st Postop. Mo. | 3rd Postop. Mo | 6th Postop. Mo | |
Age, gender, BMI a, No. of levels | X | |||
Sedentary lifestyle, smoking | X | |||
SAH b, diabetes, other comorbities | X | |||
MRI c (Modic changes) | X | |||
VNS d, DN4 e, ODI f | X | X | X | X |
EuroQol questionnaire (EQ-5D) | X | X | ||
Time off work | X | X | X |
Variable | Category | Global (n = 23) | C. acnes (−) (n = 15) | C. acnes (+) (n = 8) | p-Value |
---|---|---|---|---|---|
Gender | Female | 52.2% | 60.0% | 37.5% | 0.400 a |
Male | 47.8% | 40.0% | 62.5% | ||
BMI | Normal weight | 21.7% | 20.0% | 25.0% | 0.728 b |
Overweight | 34.8% | 40.0% | 25.0% | ||
Obesity I | 30.4% | 26.7% | 37.5% | ||
Obesity II | 13.0% | 13.3% | 12.5% | ||
Comorbidities | Diabetes | 47.8% | 33.3% | 75.0% | 0.089 a |
Obesity | 43.5% | 40.0% | 50.0% | 0.667 a | |
SAH c | 39.1% | 40.0% | 37.5% | 1.000 a | |
Bad Habits | Smoking | 39.1% | 26.7% | 62.5% | 0.179 a |
Sedentary Lifestyle | 60.9% | 53.3% | 75.0% | 0.400 a | |
Preop. Pain | Sciatica | 56.5% | 53.3% | 62.5% | 1.000 a |
Mechanics | 43.5% | 46.7% | 37.5% | ||
Preop DN4 d | ≤1 | 26.1% | 26.7% | 25.0% | 0.899 a |
2 | 47.8% | 40.0% | 62.5% | ||
3 | 21.7% | 26.7% | 12.5% | ||
≥4 | 4.3% | 6.7% | 0.0% | ||
Preop ODI e | Minimal/Moderate | 47.8% | 53.3% | 37.5% | 0.294 b |
Severe/Crippled | 52.2% | 46.7% | 62.5% | 0.667 a |
Number of Patients | 23 |
Number of evaluated discs | 53 |
Number of discs samples | 265 |
Number of C. acnes positive patients | 8 |
Number of C. acnes positive discs | 18 |
Number of C. acnes positive samples | 79 |
Prevalence of C. acnes positive patients | 34.8% |
Variable | Category | Global (n = 23) | C. acnes (−) (n = 15) | C. acnes (+) (n = 8) | p-Value |
---|---|---|---|---|---|
Preoperative DN4 | Absent | 26.1% | 26.7% | 25.0% | 0.776 a |
Possible | 21.7% | 26.7% | 12.5% | ||
Probable | 47.8% | 40.0% | 62.5% | ||
Present | 4.3% | 6.7% | 0.0% | ||
DN4 1st month | Absent | 26.1% | 26.7% | 25.0% | 0.265 a |
Possible | 47.8% | 73.3% | 0.0% | ||
Probable | 13.0% | 0.0% | 37.5% | ||
Present | 13.0% | 0.0% | 37.5% | ||
DN4 3rd month | Absent | 43.5% | 60.0% | 12.5% | 0.019 a |
Possible | 0,0% | 0.0% | 0.0% | ||
Probable | 17.4% | 10.0% | 12.5% | ||
Present | 39.1% | 10.0% | 75.0% | ||
DN4 6th month | Absent | 60.0% | 60.0% | 0.0% | 0.011 a |
Possible | 6.7% | 6.7% | 0.0% | ||
Probable | 13.3% | 13.3% | 12.5% | ||
Present | 20.0% | 20.0% | 87.5% |
Domain | Assessment | Median Score in the Domain | ||
---|---|---|---|---|
C. acnes (−) | C. acnes (+) | p-Value b (Mann– Whitney b) | ||
Mobility | Preoperative | 2.0 | 2.0 | 0.169 |
Postoperative (6th month) | 1.0 | 1.0 | 0.213 | |
0.008 a | 0.025 a | - | ||
Self-Care | Preoperative | 1.0 | 1.0 | 0.169 |
Postoperative (6th month) | 1.0 | 1.0 | 0.056 | |
0.083 a | 0.157 a | - | ||
Usual Activities | Preoperative | 1.5 | 1.5 | 0.875 |
Postoperative (6th month) | 1.0 | 1.0 | 1.000 | |
0.025 a | 0.046 a | - | ||
Pain or Discomfort | Preoperative | 2.0 | 3.0 | 0.591 |
Postoperative (6th month) | 1.0 | 2.0 | 0.825 | |
0.001 a | 0.014 a | - | ||
Anxiety or Depression | Preoperative | 2.00 | 2.00 | 0.548 |
Postoperative (6th month) | 1.00 | 1.00 | 0.131 | |
0.008 a | 0.025 a | - | ||
EQVas c | Preoperative | 80.0 | 90.0 | 1.000 |
Postoperative (6th month) | 30.0 | 60.0 | 0.875 | |
p-valor teste Wilcoxon a | 0.001 a | 0.011 a | - |
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da Rocha, V.M.; Lima, C.O.G.X.; Candido, G.B.; Mara Cassiano, K.; Lewandrowski, K.-U.; de Oliveira Ferreira, E.; Fiorelli, R.K.A. Would Cutibacterium acnes Be the Villain for the Chronicity of Low Back Pain in Degenerative Disc Disease? Preliminary Results of an Analytical Cohort. J. Pers. Med. 2023, 13, 598. https://doi.org/10.3390/jpm13040598
da Rocha VM, Lima COGX, Candido GB, Mara Cassiano K, Lewandrowski K-U, de Oliveira Ferreira E, Fiorelli RKA. Would Cutibacterium acnes Be the Villain for the Chronicity of Low Back Pain in Degenerative Disc Disease? Preliminary Results of an Analytical Cohort. Journal of Personalized Medicine. 2023; 13(4):598. https://doi.org/10.3390/jpm13040598
Chicago/Turabian Styleda Rocha, Vinícius Magno, Carla Ormundo Gonçalves Ximenes Lima, Gustavo Baptista Candido, Keila Mara Cassiano, Kai-Uwe Lewandrowski, Eliane de Oliveira Ferreira, and Rossano Kepler Alvim Fiorelli. 2023. "Would Cutibacterium acnes Be the Villain for the Chronicity of Low Back Pain in Degenerative Disc Disease? Preliminary Results of an Analytical Cohort" Journal of Personalized Medicine 13, no. 4: 598. https://doi.org/10.3390/jpm13040598