International Orthopaedics

, Volume 40, Issue 6, pp 1291–1298 | Cite as

Overview: the role of Propionibacterium acnes in nonpyogenic intervertebral discs

  • Zhe Chen
  • Peng CaoEmail author
  • Zezhu Zhou
  • Ye Yuan
  • Yucheng Jiao
  • Yuehuan Zheng
Review Article


Propionibacterium acnes (P. acnes), an important opportunistic anaerobic Gram-positive bacterium, causes bone and joint infections, discitis and spondylodiscitis. Accumulated evidence suggested that this microbe can colonise inside intervertebral discs without causing symptoms of discitis. Epidemiological investigation shows that the prevalence ranges from 13 % to 44 %. Furthermore, colonisation by P. acnes inside nonpyogenic intervertebral discs is thought to be one pathogen causing sciatica, Modic changes and nonspecific low back pain. Specially, patients can attain significant relief of low back pain, amelioration of Modic changes and alleviation of sciatica after antibiotic therapy, indicating the role of P. acnes in these pathological changes. However, until now, there were hypotheses only to explain problems such as how P. acnes access intervertebral discs and what the exact pathological mechanism it employs during its latent infection period. In addition, research regarding diagnostic procedures and treatment strategies were also rare. Overall, the prevalence and possible pathological role that P. acnes plays inside nonpyogenic intervertebral discs is summarised in this paper.


P. acnes Nonpyogenic intervertebral discs Sciatica Modic changes Nonspecific low back pain 



This work was supported by grants from the Science and Technology Commission of Shanghai Municipality, Shanghai, China (NO.13430722100) and grants from the Shanghai Bureau of Health, Shanghai, China (No. XBR2011024).


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Copyright information

© SICOT aisbl 2016

Authors and Affiliations

  • Zhe Chen
    • 1
    • 2
  • Peng Cao
    • 1
    • 2
    Email author
  • Zezhu Zhou
    • 1
    • 2
  • Ye Yuan
    • 1
  • Yucheng Jiao
    • 1
    • 2
  • Yuehuan Zheng
    • 3
  1. 1.Department of Orthopedics, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  2. 2.Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine, Shanghai Institute of Traumatology and Orthopedics, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  3. 3.Department of Orthopedics, Ruijin Hospital NorthShanghai Jiaotong University School of MedicineShanghaiChina

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