Abstract:
Back pain associated with lumbar disc herniation is a common musculoskeletal
disorder that leads to absence at work place worldwide. Studies have
proven in addition to the traditional factors, microbes play a role in disc herniation
causing chronic back pain. A 34-year-old male who has not involved
in any traumatic work but has a family history of disc herniation presented
with lower back pain and numbness in his right leg. He had previously undergone
lumbar discectomy at L4/L5 ten years back. Magnetic Resonance Imaging
(MRI) showed L5/S1 right para central disc herniation impinging on the
right S1 and S2 nerve roots. Standard protocols for disinfection of instruments,
external skin and all transport media were adhered. Skin scrapings,
muscle biopsy and excised disc tissue were obtained for anaerobic and aerobic
bacterial cultures. Anaerobic microbial cultures of excised disc tissue following
lumbar discectomy showed Gram positive growth. Further anaerobic isolation
carried out using RapID ANA ID kit confirmed the growth as Gemella
morbillorum. In addition, neither of the control samples (muscle nor skin)
had any anaerobic growth indicating the absence of contamination. Aerobic
bacterial growth was not present in the skin, muscles and disc cultures. The
study findings add to the available literature, on the role of microorganisms in
lumbar disc herniation and future treatment regimens with antibiotics.
