Methods: We performed a prospective uncontrolled case series of patients undergoing microdiscectomy for symptomatic disc degeneration or herniation. Subjects were greater than 18 years old, non-pregnant, with chronic low back pain, and meeting standard criteria for microdiscectomy. After giving informed consent, data were extracted from existing medical records and cultures of disc material were obtained at discectomy prior to perioperative prophylactic antibiotics, and were processed by standard methodology for aerobic, anaerobic and acid-fast bacterial growth.
Results: Thirty-three patients were included in the study, mean age 52.6 (SE 3.1), 19 females and 14 males. The study was terminated after these 33 cases when only one aerobic culture was positive from one male subject, and this for a minimal growth of Staphylococcus epidermidis.
Conclusion: If a significant fraction of chronic low back pain is indeed caused by chronic infection with low-virulence bacteria, this would be a paradigm shift in the evaluation and management of a common and often debilitating condition. In our study of patients with chronic low back pain undergoing microdiscectomy we did not find evidence of chronic low-virulence bacterial infection.
G. Dunbar, None