{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:33:56Z","timestamp":1762529636479,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental and Applied Research Programme of the Latvian Council of Science","award":["lzp-2024\/1\/0303"],"award-info":[{"award-number":["lzp-2024\/1\/0303"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Preoperative cefazolin is the standard of care for intervertebral disc surgery as it reduces the incidence of iatrogenic spondylodiscitis. The aim of this study was to determine the impact of intervertebral disc degeneration and endplate changes on the penetration of prophylactic cefazolin into the intervertebral disc during spinal surgery. Materials and Methods: Adult patients undergoing single-level microdiscectomy for lumbar disc herniation received prophylaxis with 2 g of cefazolin. Venous blood and intervertebral disc samples were collected and analyzed using high-performance liquid chromatography to determine cefazolin concentrations. The severity of intervertebral disc and endplate changes was assessed on magnetic resonance images using the Pfirrmann and Modic grading systems. Results: Cefazolin concentrations were significantly higher in cases with Modic type II changes compared to type 0\/I (14.6 \u00b1 9.2 \u00b5g g\u22121 vs. 10.2 \u00b1 4.5 \u00b5g g\u22121 and 9.2 \u00b1 4.1 \u00b5g g\u22121; p = 0.01). 35.4% of patients with Modic type II changes had concentrations &gt; 16 \u00b5g g\u22121, compared to 10% and 25% for patients with Modic type 0\/I (p = 0.008). For Pfirrmann grading, 34.6% of grade V discs reached &gt;16 \u00b5g g\u22121 versus 16.7% and 20.3% for grades III and IV (p = 0.26). Patient age, weight, and timing showed no significant correlations with intradisc concentrations. Conclusions: Ninety-four percent of disc samples exceeded the minimum inhibitory concentration for Staphylococcus aureus (&gt;4 \u00b5g\/g), but considerable variability in cefazolin levels was observed, with higher concentrations in discs showing Modic type II changes.<\/jats:p>","DOI":"10.3390\/medicina61111999","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:55:15Z","timestamp":1762527315000},"page":"1999","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Intervertebral Disc Degeneration and Endplate Changes on Cefazolin Penetration into the Intervertebral Disc"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5322-6863","authenticated-orcid":false,"given":"Aleksejs","family":"Repnikovs","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Department of Spine and Joint Surgery, Hospital of Traumatology and Orthopaedics, LV-1005 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalvis","family":"Briuks","sequence":"additional","affiliation":[{"name":"Department of Spine and Joint Surgery, Hospital of Traumatology and Orthopaedics, LV-1005 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7446-1294","authenticated-orcid":false,"given":"Art\u016brs","family":"Paulausks","sequence":"additional","affiliation":[{"name":"Laboratory of Finished Dosage Forms, Faculty of Pharmacy, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6403-8476","authenticated-orcid":false,"given":"P\u0113teris","family":"Studers","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Department of Spine and Joint Surgery, Hospital of Traumatology and Orthopaedics, LV-1005 Riga, Latvia"},{"name":"Joint Laboratory of Traumatology and Orthopaedics, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-0852","authenticated-orcid":false,"given":"Konstant\u012bns","family":"Logviss","sequence":"additional","affiliation":[{"name":"Laboratory of Finished Dosage Forms, Faculty of Pharmacy, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9188-5681","authenticated-orcid":false,"given":"Baiba","family":"Mauri\u0146a","sequence":"additional","affiliation":[{"name":"Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia"},{"name":"Department of Applied Pharmacy, Faculty of Pharmacy, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9144-8799","authenticated-orcid":false,"given":"Dace","family":"Bandere","sequence":"additional","affiliation":[{"name":"Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia"},{"name":"Department of Applied Pharmacy, Faculty of Pharmacy, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4418-8055","authenticated-orcid":false,"given":"J\u0101nis","family":"Kurlovi\u010ds","sequence":"additional","affiliation":[{"name":"Bioinformatics Group, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-3238","authenticated-orcid":false,"given":"Sigita","family":"Kaz\u016bne","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Department of Anesthesiology, Hospital of Traumatology and Orthopedics, LV-1005 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"ref_1","unstructured":"European Centre for Disease Prevention and Control (2019). 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Agents"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1999\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:29:55Z","timestamp":1762529395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":23,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["medicina61111999"],"URL":"https:\/\/doi.org\/10.3390\/medicina61111999","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]}}}