Is Propionibacterium acnes related to disc degeneration in adults? A systematic review.
BACKGROUND
The aim of this paper was to systematically review the evidence linking Propionibacterium acnes (P. acnes) with the development of symptomatic degenerative disc disease.


METHODS
Data were obtained from MEDLINE from their inception to October 2015. Two authors independently conducted the searches, extracted data and completed methodological quality assessments. Articles were included if they investigated the presence of P. acnes in symptomatic degenerative disc disease through intra-operative cultural examination. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale.


RESULTS
Overall 641 articles were retrieved with 9 cross-sectional studies being included in the review. All selected studies revealed an association between P. acnes and disc degeneration.


CONCLUSIONS
This study shows that there is a relationship between P. acnes and development of symptomatic degenerative disc disease. Despite this, we cannot support that P. acnes and development of symptomatic degenerative disc disease due to the low quality of the results according Grading of Recommendations Assessment, Development and Evaluation (GRADE).
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Pedro
P
Berjano
IRCCS Don Gnocchi Foundation, Milan, Italy - mail@villafane.it.
Jorge H
JH
Villafañe
University of Palermo, Palermo, Italy.
Dario
D
Lo Re
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Maryem
M
Ismael
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Marco
M
Damilano
University of Bologna, Bologna, Italy.
Lucia
L
Bertozzi
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Carlo L
CL
Romanò
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.|IRCCS Don Gnocchi Foundation, Milan, Italy.|University of Palermo, Palermo, Italy.|University of Bologna, Bologna, Italy.|University of Milan, Milan, Italy.
Lorenzo
L
Drago
D000328:Adult; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology*; D011425:Propionibacterium acnes