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As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between 2015 and 2017, 40 adults with LDH\/LBP (median age 43, IQR 33\u201349) and 20 control patients with scoliosis (median age 17, IQR 15\u201320) underwent surgery at seven Swedish hospitals. Samples were cultured from skin, surgical wound, discs and vertebrae. Genetic relatedness of <jats:italic>C. acnes<\/jats:italic> isolates was investigated using single-nucleotide polymorphism analysis. DNA samples collected from discs\/vertebrae were analysed using 16S rRNA-based PCR sequencing. MRI findings were assessed for Modic changes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>No bacterial growth was found in 6\/40 (15%) LDH patients, compared with 3\/20 (15%) scoliosis patients. Most positive samples in both groups were isolated from the skin and then from subcutis or deep within the wound. Of the four disc and vertebral samples from each of the 60 patients, 235\/240 (98%) were DNA negative by bacterial PCR. A single species, <jats:italic>C. acnes<\/jats:italic>, was found exclusively in the disc\/vertebra from one patient in each group. In the LDH group, 29\/40 (72%) patients had at least one sample with growth of <jats:italic>C. acnes,<\/jats:italic> compared to 14\/20 (70%) in the scoliosis group. Bacterial findings and Modic changes were not associated.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p><jats:italic>Cutibacterium acnes<\/jats:italic> found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and\/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and\/or low back pain, without signs of clinical discitis\/spondylitis, should be seriously questioned.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Graphic abstract<\/jats:title>\n<jats:p>These slides can be retrieved under Electronic Supplementary Material.<\/jats:p>\n\n<\/jats:sec>","DOI":"10.1007\/s00586-019-06164-1","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T18:10:22Z","timestamp":1569953422000},"page":"2981-2989","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Bacteria: back pain, leg pain and Modic sign\u2014a surgical multicentre comparative study"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2043-6376","authenticated-orcid":false,"given":"Peter","family":"Fritzell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Welinder-Olsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodil","family":"J\u00f6nsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Melhus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siv G. 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