Abstract
Introduction
Studies that implicate disc infection in the majority of patients with axial back/neck pain or leg/arm pain is potentially scandalous and irresponsible. The majority of these studies are underpowered and lack a contaminant arm, the current study is aimed to fulfil these basic criteria.
Material and Methods
A prospective case–control multicentric study (HREC 13/218) including cases discectomy for degenerative disc pathology and controls are patients undergoing discectomy for nondegenerate pathology. True disc positivity was inferred if the culture of disc was positive and the paraspinal tissue sample was negative. A total of 400 patients have been enrolled. In degenerative disc cases, 8.7% were true positive (disc +ve/paraspinal −ve) with paraspinal-positive samples in 38.4% on its own. In control cases there was 40% positive for disc culture together with paraspinal tissue. The organisms in disc or paraspinal culture were very similar with 85% having same organisms. On generalized linear model analysis of disc-culture positivity using binomial sets there were no statistical significant findings when comparing disc positivity to demography, type of surgery, modic changes or level of surgery.
Conclusions
(1) The true rate of disc culture positivity in the degenerative disc population is significantly lower than previous literature reports. (2) At the interim analysis stage, the DISC study heavily favors performing disc cultures strictly with a contaminant control.