Is eindplaatoedeem van wervellichamen een oorzaak van lage-rugpijn? Mogelijk spelen bacteri"en een rol

Translated title of the contribution: Is bone marrow edema a cause of low back pain? A possible role of bacteria: A possible role of bacteria

Jan M A Mens*, Frank J P M Huygen, Wilco C Peul, Angelique E A M Weel, Bart W Koes

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Lumbar bone marrow edema, also known as Modic type-1 endplate change, has a prevalence of 43% in low back pain populations and 6% in general populations. Besides mechanical factors and genetic predisposition it has been hypothesized that lumbar bone marrow edema is caused by a latent infection of low-virulence anaerobic bacteria in degenerated lumbar intervertebral discs. The hypothesis is supported by the observation that the presence of Cutibacterium acnes is more frequently found in samples of disci with Modic-1 than in discs without and by the positive effects of antibiotics in patients with back pain and Modic-1 as shown in placebo-controlled RCT's. Opponents of the hypothesis argue that the findings of bacteria are most likely a result of contamination during harvesting the samples. We conclude that time has come to make a start in the Netherlands with treatment with antibiotics of a small group of well-selected patients in well-selected clinics.

Translated title of the contributionIs bone marrow edema a cause of low back pain? A possible role of bacteria: A possible role of bacteria
Original languageDutch
Article numberD6304
JournalNederlands Tijdschrift voor Geneeskunde
Volume166
Publication statusPublished - 17 Feb 2022

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