Human Microbiome and its Role in the Development of Lumbar Spine Degeneration and Modic Changes

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Summary Chronic low back pain (LBP) is the world’s most disabling condition, whose management outcomes are often unsatisfactory and health-care costs worldwide are astronomical. Modic changes Type 1 (MC1: subchondral bone marrow lesions adjacent to the endplate that are associated with inflammation) on magnetic resonance imaging (MRI) are highly associated with the development and severity of chronic LBP. The etiology of MC1 remains speculative. Systemic inflammatory and metabolomic biomarkers have been associated with MCI; however, still under scrutiny. Intervertebral disc degeneration (DD) in general has been associated with bacterial invasion, but not replicated and questionable. The human microbiome has been associated with a string of human diseases. The following proposal aims to identify if lumbar MC1 are associated with the pro-inflammatory nature of the intestinal microbiome compared to non-MC1 intervertebral discs. Integrative approaches taking into account the microbiome, metabolomics and systemic inflammatory markers will also be addressed in relation to MCI of the lumbar spine.