Herpes virus infection can cause intervertebral disc degeneration

Alpantaki, Kalliopi; Katonis, Pavlos; Hadjipavlou, A. G.; Spandidos, Demetrios Α.; Sourvinos, George

doi:10.1302/0301-620x.93b9.27002

Cited by 28 publications

(38 citation statements)

References 38 publications

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“…This same study found aerobic and anaerobic bacteria in the nuclear tissue of lumbar discs in patients undergoing spinal surgery for disc herniation which may be associated with the bone oedema [7]. Two recent studies found the presence of bacteria [8] and viruses [9] in the intervertebral discs of patients treated for lower back pain and both were postulated to be associated with disc herniation and/or degeneration. In the Alpantaki et al study [9] the authors assessed the incidence of herpesviruses in intervertebral disc specimens from patients who underwent surgery for lumbar disc herniation.…”

Section: Introductionmentioning

confidence: 72%

“…Two recent studies found the presence of bacteria [8] and viruses [9] in the intervertebral discs of patients treated for lower back pain and both were postulated to be associated with disc herniation and/or degeneration. In the Alpantaki et al study [9] the authors assessed the incidence of herpesviruses in intervertebral disc specimens from patients who underwent surgery for lumbar disc herniation. A polymerase chain reaction, nucleic acid hybridization assay was applied to screen for the DNA of eight different herpes viruses in 16 patients and two controls.…”

Section: Introductionmentioning

confidence: 99%

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Are viruses associated with disc herniation? A clinical case series

Walker

Armson

O’Dea

et al. 2020

BMC Musculoskelet Disord

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Background: There is some limited evidence for the presence of viruses in herniated disc material including a previous case series that claimed to provide "unequivocal evidence of the presence of herpes virus DNA in intervertebral disc specimens of patients with lumbar disc herniation suggesting the potential role of herpes viruses as a contributing factor to the pathogenesis of degenerative disc disease". This study has not been replicated. The objective of our study was to determine if viruses were present in herniated disc fragments in participants with a prior history of back pain. Methods: We recruited fifteen participants with a history of prior low-back pain prior to undergoing disc herniation surgery in the lumbar spine. Harvested disc samples were subject to next generation sequencing for detection of both RNA and DNA viral pathogens. Additionally, samples were analysed by a broadly reactive PCR targeting herpesviral DNA. Ethics approval was granted by the

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Section: Introductionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Are viruses associated with disc herniation? A clinical case series

Walker

Armson

O’Dea

et al. 2020

BMC Musculoskelet Disord

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“…For example, we know that IVD cells become dysfunctional with possible contributory factors including reduction in the blood supply, inheritance 3,5 or even viral infection. 6 However, there remain many gaps in our knowledge, such as the exact pathways involved that lead to deleterious consequences.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Genetics and ethnicity have also been shown to have a role in degeneration of the IVD, 3,5 and recently it has been suggested that herpes simplex virus type-1 (HSV-1) together with cytomegalovirus can be isolated from the intervertebral discs of patients with back pain undergoing surgery. 6 Evidence of spinal degeneration is present in between 90% and 100% of people aged > 63 years 7 and is seen in autopsy studies even in the absence of any known history of LBP. 8 This demonstrates the relatively poor association between the radiological evidence of disc degeneration and the clinical presence of pain.…”

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confidence: 99%

The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain

Hughes

Freemont

Hukins

et al. 2012

The Journal of Bone and Joint Surgery. British volume

112

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This article reviews the current knowledge of the intervertebral disc (IVD) and its association with low back pain (LBP). The normal IVD is a largely avascular and aneural structure with a high water content, its nutrients mainly diffusing through the end plates. IVD degeneration occurs when its cells die or become dysfunctional, notably in an acidic environment. In the process of degeneration, the IVD becomes dehydrated and vascularised, and there is an ingrowth of nerves. Although not universally the case, the altered physiology of the IVD is believed to precede or be associated with many clinical symptoms or conditions including low back and/or lower limb pain, paraesthesia, spinal stenosis and disc herniation. New treatment options have been developed in recent years. These include biological therapies and novel surgical techniques (such as total disc replacement), although many of these are still in their experimental phase. Central to developing further methods of treatment is the need for effective ways in which to assess patients and measure their outcomes. However, significant difficulties remain and it is therefore an appropriate time to be further investigating the scientific basis of and treatment of LBP.

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“…Governments and non-profit organizations need to fund research in high-volume institutions in order to duplicate the results of Albert et al Only after these are confirmed by other researchers, should we begin to act on their findings in terms of new therapies. And we should be prepared for surprise results by such research: There is a recent study, which suggests that disc degeneration may be caused by viral infections [67]. Disc degeneration by means of viruses, chronic low back pain and Modic changes by means of anaerobic bacteria?…”

Section: Discussionmentioning

confidence: 99%

Should We Start Treating Chronic Low Back Pain with Antibiotics Rather than with Pain Medications?

Birkenmaier

2013

Korean J Pain

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For those of us who have read the 2 recently published articles by a Danish - British research group, it might appear that we are observing an impending paradigm shift on the origins of chronic low back pain. The results of this research indicate, that chronic low back pain associated with bone marrow edema in vertebral endplates that are adjacent to herniated intervertebral discs may be caused by infections with anaerobic bacteria of low virulence. According to these articles, treatment with certain antibiotics is significantly more effective than placebo against this low back pain. If these findings are to hold true in repeat studies by other researchers, they stand to fundamentally change our concepts of low back pain, degenerative disc disease and in consequence the suitable therapies for these entities. It may in fact require pain specialists to become familiarized with the details of antibiotic treatments and their specific risks in order to be able to properly counsel their patients. While this seems hard to believe at first glance, bacteria have been implicated in the pathogenesis of other conditions that do not primarily impose as infectious diseases such as gastric ulcers. While the authors refer to a few previous studies pointing into the same direction, the relevant research is really only from one group of collaborating scientists. Therefore, before we start prescribing antibiotics for chronic low back pain, it is imperative that other researchers in different institutions confirm these results.

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Herpes virus infection can cause intervertebral disc degeneration

Cited by 28 publications

References 38 publications

Are viruses associated with disc herniation? A clinical case series

Are viruses associated with disc herniation? A clinical case series

The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain

Should We Start Treating Chronic Low Back Pain with Antibiotics Rather than with Pain Medications?

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