Summary
After treatment of a symptomatic herniated disc with chymopapain, 14 patients were re-examined by magnetic resonance imaging (MRI) at a mean follow-up of 72 months. Well-defined MRI findings before chemonucleolysis were compared with those after the procedure by an independent observer. Five MRI parameters were assessed. No significant change was noted in the signal intensity of the affected disc, the extent of osteochondrosis and endplate reaction of the affected segment. The height of the affected disc as well as the size of the disc herniation were reduced significantly. The loss of the height is seen as a direct result of chymopapain activity, whereas the alteration of the size of the herniation seems to depend on the natural history of a disc herniation and is probably not a simple result of the treatment.
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References
Assheuer J, Jerosch J, Schulitz KP (1992) Diurnal changes in water content and shape of the degenerated disc. Presented at the 19th annual meeting of the International Society for the Study of the Lumbar Spine, Chicago, 20–24 May
Block JA, Schnitzer TJ, Andersson GBJ et al (1989) The effect of chemonucleolysis on serum keratan sulfate levels in humans. Arthritis Rheum 32:100–104
Boumphrey FRS, Bell GR, Modic M et al (1987) Computed tomography scanning after chymopapain injection for herniated nucleus pulposus: a prospective study. Clin Orthop 219:120–123
Flanagan MN, Chung BU (1986) Roentgenographic changes in 188 patients 10–20 years after discography and chemonucleolysis. Spine 11:444–448
Jantea C, Assheuer J, Schoppe K et al (1989) Results of magnetic resonance imaging (MRI) investigation before and after automated percutaneous lumbar discectomy (APLD) — comparison of MRI findings and clinical health status. In: Mayer H, Brock M (eds) Percutaneous lumbar discectomy. Springer, Berlin Heidelberg, New York, pp 72–83
Konings JG, Williams FJB, Deutman R (1986) Computed tomography (CT) analysis of the effects of chemonucleolysis. Clin Orthop 206:32–36
Lange SA de (1985) Chemonucleolysis of the intervertebral discus using chymopapain (in Dutch). Geneesmiddelenbulletin 19:9–11
Maigne JY, Rime B, Deligne B (1992) Computed tomographic follow-up study of 48 cases of nonoperatively treated lumbar intervertebral disc herniation. Spine 17:1071–1074
Nicolas V, Krahe T, Dewes W et al (1987) MR-Tomographie zur Therapiekontrolle nach Chemonukleolyse. Fortschr Rontgenstr 147:537–542
Roggendorf W, Brock M, Gorge HH et al (1984) Morphological alterations'of the degenerated lumbar disc following chemonucleolysis with chymopapain. J Neurosurg 60:518–522
Saal JA, Saal JS, Herzog RJ (1990) The natural history of lumbar intervertebral disc extrusions treated nonoperatively. Spine 15:683–689
Stern IJ (1969) Biochemistry of chymopapain. Clin Orthop 67:42–46
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Castro, W.H.M., Halm, H., Jerosch, J. et al. Long-term changes in the magnetic resonance image after chemonucleolysis. Eur Spine J 3, 222–224 (1994). https://doi.org/10.1007/BF02221597
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DOI: https://doi.org/10.1007/BF02221597