gms | German Medical Science

Objective: In the year 2011 a high spread of infection of HSV1 and CMV was detected in 16 disc sequestra of patients with lumbar disc herniation (K. Alpantaki et al. 2011). The present study was designed to verify this data with a larger number of cases and to eventually extend the data with disc tissue from a healthy control group.

Method: Out of 45 patients with lumbar or cervical disc herniation that underwent spinal surgery, the disc sequestra were tested for HSV and CMV by PCR (cervical prolapse n=15; lumbar prolapse n=30). After surgical excision of the sequestra the sample tissue was placed in RNA-later and stored at -20°C until the virological analysis was made. Initially samples of the patients' blood serum were screened with ELISA for IgG antibodies. After the mechanical comminution of the disc material the nucleic acid was automatically extracted. Subsequently the viral nucleic acid was detected with quantitative polymerase chain reaction. Prion Protein DANN was added to the lysis buffer before the extraction as a combined extraction and inhibition control. The validity of the PCR tests was assured through positive controls and standards, which need to be in a certain target range.

Results: Without exception, all 45 disc samples show negative PCR-results for HSV and CMV, while the internal control is in the expected normal range. The serological testing for both viruses of our patient collective showed a 82% IgG-postive result for HSV and a 51% IgG-positive result for CMV, corresponding to the available data in literature for the spread of infection in the average population.

Conclusions: The results of the PCR did not manifest any evidence of viruses in the examined disc tissue, although the serological testing revealed an expected spread of infection for the stated viruses in our patient population. Consequently, HSV and CMV do not seem to have any direct influence on the genesis of disc herniation in the lumbar and cervical spine in our patient collective.