BACKGROUND There is some limited evidence for the presence of viruses in herniated disc material including a previous case series that claimed to provide "unequivocal evidence of the presence of herpes virus DNA in intervertebral disc specimens of patients with lumbar disc herniation suggesting the potential role of herpes viruses as a contributing factor to the pathogenesis of degenerative disc disease". This study has not been replicated. The objective of our study was to determine if viruses were present in herniated disc fragments in participants with a prior history of back pain. METHODS We recruited fifteen participants with a history of prior low-back pain prior to undergoing disc herniation surgery in the lumbar spine. Harvested disc samples were subject to next generation sequencing for detection of both RNA and DNA viral pathogens. Additionally, samples were analysed by a broadly reactive PCR targeting herpesviral DNA. Ethics approval was granted by the Human Research Ethics Committees of both Murdoch University, and St John of God Hospital, Western Australia. RESULTS Of the fifteen research participants, 8 were female. Mean age was 49.4 years (SD 14.5 yrs) with a range of 24-70 years. All participants had prior back pain with mean time since first ever attack being 8.8 years (SD 8.8 yrs). No samples contained significant DNA sequences relating to known human viral agents. Inconsequential retroviral sequences were commonly found and were a mixture of putative animal and human retroviral protein coding segments. All samples were negative for herpesvirus DNA when analysed by pan-herpesvirus PCR. CONCLUSIONS This study found no viral pathogens in any intervertebral disc fragments of patients who had previous back pain and underwent discectomy for disc herniation and thus it is unlikely that viruses are associated with disc herniation, however given the contradiction between key studies enhanced replication of this experiment is recommended.

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病毒与椎间盘突出症相关吗？临床病例系列。

背景技术在椎间盘突出的材料中存在一些有限的证据，包括先前的病例系列，该系列声称“提供了腰椎间盘突出症患者椎间盘标本中疱疹病毒DNA的明确证据，提示了疱疹的潜在作用”。病毒是导致椎间盘退变疾病发病机理的重要因素”。该研究尚未重复。我们研究的目的是确定先前有背痛病史的参与者的椎间盘突出物中是否存在病毒。方法我们招募了15位有腰椎间盘突出症手术前先有过腰背痛病史的参与者。将收获的圆盘样品进行下一代测序，以检测RNA和DNA病毒病原体。另外，通过针对疱疹病毒DNA的广泛反应性PCR分析样品。伦理学批准由默多克大学和西澳大利亚的圣约翰医院的人类研究伦理委员会授予。结果在15名研究参与者中，有8名是女性。平均年龄为49.4岁（标准差14.5岁），范围为24-70岁。自首次发作以来，所有参与者均曾经历过背痛，平均时间为8.8年（SD 8.8岁）。没有样品包含与已知人类病毒制剂有关的重要DNA序列。通常发现无关紧要的逆转录病毒序列，并且是假定的动物和人类逆转录病毒蛋白编码片段的混合物。当通过全疱疹病毒PCR分析时，所有样品的疱疹病毒DNA均为阴性。结论这项研究发现以前有腰背痛并接受椎间盘切除术治疗椎间盘突出症的患者的任何椎间盘碎片中均未发现病毒病原体，因此病毒与椎间盘突出症相关的可能性不大，但是鉴于关键研究之间的矛盾增强了该实验的重复性被推荐。