Are MODIC Type 2 disc changes associated with low-grade infections? A pilot study.

BACKGROUND: The aim of this study is to compare intra-operative cultural examination in patients undergoing elective surgery for low-back pain with Modic 2 changes to patients without Modic signs. The aim of this study is to compare intra-operative cultural examination in patients undergoing elective surgery for low-back pain with Modic 2 changes to patients without Modic signs.

METHODS: Sixteen patients with Modic 2 changes were compared with 23 patients without Modic signs. Pre-operative laboratory tests and intra-operative tissue cultures were performed, according to a standardized procedure.

RESULTS: While no difference was found in pre-operative laboratory tests, intra-operative cultural examination showed positive results in 6/16 (37.5%) Modic 2 patients versus 1/23 (4.3%) in patients without Modic changes (P=0.012).

CONCLUSIONS: Although performed in a limited series of patients, this study supports the hypothesis that some cases of Modic 2 changes might be associated with the presence of low virulent bacteria.