The Role of Cutibacterium Acnes in the Development of Degenerative Lumbar Intervertebral Disc Disease

Inclusion Criteria: * minimum age of 18 years * MRI of the lumbosacral spine performed one month ± 2weeks before surgery showing a disc protrusion, herniation, or free nucleus pulposus sequestration * matching physical examination findings including positive straight leg raise test, dermatomal sensory deficits, myotome motor deficits, and diminished deep tendon reflexes. Exclusion Criteria: * antibiotics or corticosteroid use the month before surgery * ongoing bacterial or viral infection * immunocompromised patient * trauma * undefined radiological mass * inflammatory arthritis * other rheumatologic diseases.