Summary
Measurements of the area of the intervertebral disc space were made, over a period of 400 days or more, in 16 patients who underwent chemonucleolysis and 20 patients after nucleotomy. The superimpositioning method of measurement used is based on a determination of fixed points and it has a high level of reproducibility. We have measured areas which differ from volumes in only a single dimension, but which show good correlation compared with measurement of intervertebral disc space heights alone. After both chemonucleolysis and nucleotomy, narrowing of the intervertebral disc space occurs up to the 50th day, after which there is a highly significant difference: the intervertebral disc space height increases after chemonucleolysis, and continues to decrease after nucleotomy. It is concluded that the enzymatic effect of chymopapain on the nucleus pulposus produces a gain in disc substance after chemonucleolysis, whereas nucleotomy is associated with a loss of substance.
Résumé
On a pratiqué, sur une période de 400 jours ou plus, des mesures de la surface de l'espace intervertébral chez 16 sujets ayant subi une chymonucléolyse et chez 20 opérés de discectomie. La méthode de mesure par superposition utilisée est basée sur la détermination de repères précis et possède un haut niveau de reproductibilité. Nous avons mesuré les surfaces, qui ne diffèrent des volumes que par une dimension, mais qui leur sont bien correlées, contrairement à la mesure isolée de la hauteur du disque. Tant après chymo-nucléolyse qu'après discectomie apparaît vers le 50e jour une diminution de l'espace intervertébral, après quoi survient une différence hautement significative: l'espace intervertébral augmente après chymo-nucléolyse, alors qu'elle continue à décroître après discectomie. On peut en conclure que l'effet enzymatique de la chymopapaïne sur le nucleus pulposus entraîne une augmentation de la substance discale tandis que la discectomie la diminue.
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Gördes, W., Feuchtgruber, G. & Fritz, W. Quantitative measurement of disc space area before and after chemonucleolysis and nucleotomy. International Orthopaedics 13, 89–93 (1989). https://doi.org/10.1007/BF00266368
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DOI: https://doi.org/10.1007/BF00266368