Identifying the key microbiome associated with lumbar discherniation in Chinese patients.

Background: Inflammation and subsequent fibrotic remodeling-characterized by extracellular matrix deposition and myofibroblast activation-are hallmark processes in various degenerative disorders. Lumbar disc herniation (LDH) involves local inflammation and disruption of extracellular matrix organization; however, the role of systemic modulators such as gut microbiota and their metabolites remains poorly understood, particularly in the Han Chinese population. Methods: A total of 69 LDH patients and 69 healthy controls were enrolled in this study. Fecal samples were subjected to 16 S rRNA sequencing, and untargeted metabolomics was performed to compare microbial diversity, taxonomic composition, and metabolic profiles between the two groups. A random forest model was constructed to evaluate the diagnostic predictive value of identified microbial and metabolic features. Results: LDH patients exhibited significant gut microbial dysbiosis, characterized by reduced alpha and beta diversity and markedly decreased abundances of Faecalibacterium and Conclusion: These findings suggest that gut microbiota may contribute to intervertebral disc degeneration by promoting chronic inflammatory responses and fibrotic structural remodeling. This study provides new insights into the inflammation-fibrosis continuum underlying spinal degeneration and identifies candidate biomarkers with potential for future translational applications.