Fritzell Peter, Bergström Tomas, Welinder-Olsson Christina
Department of Orthopedic Surgery, Center for Clinical Research Falun Hospital, 79182, Falun, Sweden.
Eur Spine J. 2004 Dec;13(8):702-6. doi: 10.1007/s00586-004-0719-z. Epub 2004 May 8.
A local inflammatory and potentially painful response, of which the ultimate cause is unknown, has been described in nervous tissues in contact with degenerated disc material in patients with low back and leg pain. With the rationale that a possible cause of such inflammation could be bacterial infection, we utilized PCR (polymerase chain reaction) amplification of the 16S rRNA (ribosomal RNA) gene followed by gene sequencing, to investigate whether bacterial DNA might be detected in the degenerative discs of 10 patients operated for disc herniation or post-discectomy syndrome. One patient with disc hernia harbored DNA homologous to Bacillus cereus, and in one patient suffering from post-discectomy syndrome, Citrobacter braaki/freundii DNA was detected. The finding demonstrates that 16S rRNA PCR can be a useful tool in search of bacterial DNA in degenerated discs, which in turn may be indicative of low-grade infection, manifesting itself only as pain rather than as clinical infection.
在患有腰腿痛的患者中,与退变椎间盘组织接触的神经组织会出现一种局部炎症反应,可能伴有疼痛,但其根本原因尚不清楚。基于这种炎症反应的一个可能原因是细菌感染的理论,我们采用聚合酶链反应(PCR)扩增16S核糖体RNA(rRNA)基因,随后进行基因测序,以研究在10例因椎间盘突出症或椎间盘切除术后综合征接受手术的患者的退变椎间盘中是否能检测到细菌DNA。1例椎间盘突出症患者的DNA与蜡样芽孢杆菌具有同源性,1例椎间盘切除术后综合征患者检测到了布氏柠檬酸杆菌/弗氏柠檬酸杆菌的DNA。这一发现表明,16S rRNA PCR可能是在退变椎间盘中寻找细菌DNA的有用工具,而这反过来可能提示存在低度感染,其仅表现为疼痛而非临床感染。