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Risk factors associated with low-grade virulent infection in intervertebral disc degeneration: a systematic review and meta-analysis.
Zhang, Mingtao; Jia, Jingwen; Deng, Liangna; Cao, Zhenyu; Hu, Xuchang; Lei, Shuanhu; Zhang, Guangzhi; Zhu, Daxue; Duan, Yanni; Kang, Xuewen.
Afiliación
  • Zhang M; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China. Electronic address: mtz1717@163.com.
  • Jia J; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Deng L; Department of Radiology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730000, Gansu, China.
  • Cao Z; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Hu X; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Lei S; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Zhang G; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Zhu D; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Duan Y; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
  • Kang X; Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China. Electronic address: ery_kangxw@lzu.edu.cn.
Spine J ; 24(6): 1034-1045, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38365007
ABSTRACT

BACKGROUND:

An increasing number of research indicates an association between low-grade bacterial infections, particularly those caused by Propionibacterium acnes (P. acnes), and the development of intervertebral disc degeneration (IDD). However, no previous meta-analysis has systematically assessed the risk factors for low-grade bacterial infections that cause IDD.

PURPOSE:

This study reviewed the literature to evaluate the risk factors associated with low-grade bacterial infection in patients with IDD. STUDY

DESIGN:

Systematic review and meta-analysis.

METHODS:

The systematic literature review was conducted using the PubMed, Web of Science, Embase, and Cochrane Library databases. Eligible articles explicitly identified the risk factors for low-grade bacterial infections in IDD patients. Patient demographics and total bacterial infection rates were extracted from each study. Meta-analysis was performed using random- or fixed-effects models, with statistical analyses conducted using Review Manager (RevMan) 5.4 software.aut.

RESULTS:

Thirty-three studies involving 4,109 patients were included in the meta-analysis. The overall pooled low-grade bacterial infection rate was 30% (range, 24%-37%), with P. acnes accounting for 25% (range, 19%-31%). P. acnes constituted 66.7% of bacteria-positive discs. Fourteen risk factors were identified, of which 8 were quantitatively explored. Strong evidence supported male sex (odds ratio [OR] = 2.15; 95% confidence interval [CI]=1.65-2.79; p<.00001) and Modic changes (MCs) (OR=3.59; 95% CI=1.68-7.76; p=.0009); moderate evidence of sciatica (OR=2.31; 95% CI=1.33-4.00; p=.003) and younger age (OR=-3.47; 95% CI=-6.42 to -0.53; p=.02). No evidence supported previous disc surgery, MC type, Pfirrmann grade, smoking, or diabetes being risk factors for low-grade bacterial infections in patients with IDD.

CONCLUSIONS:

Current evidence highlights a significant association between IDD and low-grade bacterial infections, predominantly P. acnes being the most common causative agent. Risk factors associated with low-grade bacterial infections in IDD include male sex, MCs, sciatica, and younger age.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propionibacterium acnes / Degeneración del Disco Intervertebral Límite: Humans Idioma: En Revista: Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propionibacterium acnes / Degeneración del Disco Intervertebral Límite: Humans Idioma: En Revista: Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos