Association between sciatica and Propionibacterium acnes

Alistair Stirling, Tony Worthington, Mohammed Rafiq, Peter A. Lambert, Tom S.J. Elliott

Research output: Contribution to journalArticle

Abstract

We hypothesised that the inflammation seen around the nerve root in patients with sciatica may be caused by microbial infection. We used a newly developed serological test to diagnose deep-seated infections caused by low virulent gram-positive microorganisms. 43 of 140 (31%) patients with sciatica tested positive. Intervertebral disc material from a further 36 patients with severe sciatica who had undergone microdiscectomy was cultured for the presence of microorganisms. 19 of these patients (53%) had positive cultures after long-term incubation. Propionibacterium acnes was isolated from 16 of the 19 (84%) positive samples. Low virulent microorganisms, in particular P acnes, might be causing a chronic low-grade infection in the lower intervertebral discs of patients with severe sciatica. These microorganisms could have gained access to the spinal disc after previous minor trauma.

Original languageEnglish
Pages (from-to)2024-2025
Number of pages2
JournalThe Lancet
Volume357
Issue number9273
DOIs
Publication statusPublished - 23 Jun 2001

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