Hyperbaric oxygen treatment: A complementary treatment modality of Modic changes?

Autor: Tanja Batinac, Igor Barković, Toni Valković, Lari Gorup, Mario Franolić, Vlatka Sotošek
Rok vydání: 2020
Předmět:
0301 basic medicine
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences
medicine.medical_specialty
medicine.medical_treatment
Hyperbaric oxygenation
Intervertebral Disc Degeneration
Gastroenterology
bakterijska infekcija
terapija hiperbaričnim kisikom
Modic promjene
Propionibacterium acnes
03 medical and health sciences
0302 clinical medicine
Hyperbaric oxygen
Hyperbaric oxygen therapy
Internal medicine
Humans
Medicine
chemistry.chemical_classification
Hyperbaric Oxygenation
Reactive oxygen species
Lumbar Vertebrae
biology
business.industry
BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti
Modic changes
General Medicine
Antimicrobial
biology.organism_classification
Magnetic Resonance Imaging
Oxygen
030104 developmental biology
chemistry
Treatment modality
Quality of Life
Bacterial infection
business
Adjuvant
Intervertebral Disc Displacement
030217 neurology & neurosurgery
Zdroj: Medical hypotheses
Volume 138
ISSN: 0306-9877
Popis: Modic changes (MCs) have attracted great interest in recent years. The complex process of MC development and progression seems to involve interplay between mechanical, infective, inflammatory, and degenerative processes that cannot be clearly differentiated. Based on signal intensity on T1- and T2-weighted MRI scans, MCs can be divided three types: Type 1, Type 2, and Type 3. Predominantly Type 1 MCs are commonly associated with chronic low back pain that is unresponsive to classic treatment options. Infection with low-virulent anaerobic microorganisms, most commonly Propionibacterium acnes, has been implicated in MC development following a disc herniation when a tear enables bacteria to enter the disc. Recent studies in patients with chronic low back pain following a lumbar disc herniation associated with Type 1 MCs have reported promising results following prolonged systemic antibiotic treatment with amoxicillin-clavulanate. Hyperbaric oxygen therapy, as primary or adjuvant treatment in association combination with systemic antibiotics or anti- inflammatory therapy, could offer important advantages in treating patients with suspected low- virulent disc infections due to anaerobic microorganisms associated with Type 1 MCs. We believe that hyperbaric oxygenation could contribute to faster resolution of Type 1 MCs and associated pain through multiple effects—including direct antimicrobial effects through formation of reactive oxygen species (ROS), altering the favorable low oxygen tension milieu such that it becomes unfavorable for bacterial growth and survival, and anti-biofilm effects. Additionally, hyperbaric oxygenation could contribute to faster pain resolution via direct and indirect anti- inflammatory effects. As an adjuvant treatment administered in combination with systemic antibiotics, HBOT could increase the sensitivity of Propionibacterium acnes to antimicrobial drugs under hyperoxic conditions, resulting in faster MC resolution. Overall, the faster infection resolution, diminished bacterial load, and anti- inflammatory effects due to reduced cytokine expression and levels of infectious by- products could lead to faster pain resolution following HBOT, and a significant improvement of quality of life in these patients.
Databáze: OpenAIRE
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