title: Do bacteria play an important role in the pathogenesis of low back pain?
abstract: Considerable interest has been generated recently regarding an alternative hypothesis for the pathogenesis of low back pain and radiculopathy in the presence of intervertebral disc prolapse. Traditionally, back pain and radicular (sciatic) symptoms have been attributed to mechanical compression of neural tissue by herniated disc material and to inflammation caused by exposure of the nerve roots to disc tissue. Recent research however has suggested that low-grade infection within the intervertebral disc by anaerobic bacteria may be responsible. The development of Modic changes in the corresponding adjacent vertebral endplates has also been suggested as an indicator of infection. This article is a thorough review of the current literature regarding the hypothesis that low-grade anaerobic bacterial infection may be the cause of disabling low back pain and radiculopathy.
authors: Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, South Australia, Australia.
authors: Thomas J
authors: http://orcid.org/0000-0002-3244-4621
authors: TJ
authors: Fisher
authors: Department of Surgery, Calvary Healthcare North Adelaide Campus, Adelaide, South Australia, Australia.
authors: Orso L
authors: OL
authors: Osti
mesh_terms: D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000150:complications*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications; D017116:Low Back Pain / Q000209:etiology / Q000382:microbiology*; D008159:Lumbar Vertebrae / Q000382:microbiology*; D011843:Radiculopathy / Q000209:etiology / Q000382:microbiology*
keywords: displacement/microbiology; intervertebral disc; low back pain/etiology; review