Summary
Measurements of the intervertebral disc space were made by magnetic resonance imaging and plain film examinations over a period of 2 years in 26 patients who had undergone chemonucleolysis. The height of the posterior portion of the disc decreased after 3 months and never recovered; the height of the anterior portion also decreased but recovered slightly over the same period. The angle of lordosis and the range of motion in the treated segment were decreased, but recovered. Marked decrease in signal from the disc was observed after 2 weeks which did not recover till 2 years after chemonucleolysis. We suspect that the disc degenerated markedly after chemonucleolysis and changed into a type of scar tissue, maturation of which could stabilize the affected segment.
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References
Brown MD (1983) Intradiscal therapy, chymopapain or collagenase. Year Book Medical Publishers, Chicago
McCulloch JA, Macnab I (1983) Sciatica and chymopapain. Williams and Wilkins, Baltimore
Bitz DM, Ford LT (1977) An evaluation of narrowing following intradiskal injection of chymopapain. Clin Orthop 129:191–195
Gördes W, Feuchtgruber G, Fritz W (1989) Quantitative measurement of disc space area before and after chemonucleolysis and nucleotomy. Int Orthop 13:89–93
Chafetz NI, Genant HK, Moon KL, Helms CA, Morris JM (1983) Recognition of lumbar disk herniation with NMR. AJR 141:1153–1156
Gibson MJ, Buckley J, Mulholland RC, Worthington BS (1986) The changes in the intervertebral disc after chemonucleolysis demonstrated by magnetic resonance imaging. J Bone Joint Surg [Br] 68:719–723
Huckman MS, Clark JW, McNeil TW, Whisler WW, Hejna WF, Russell EJ, Ramsey RG, Turner D (1977) Chemonucleation and changes observed on lumbar MR scan: preliminary report. AJNR 8:1–4
Kato F, Mimatsu K, Iwata H, Miura T (1990) The serial changes in the intervertebral disc after chemonucleolysis with chymopapain observed by MRI. Spine Spinal Cord 3:383–389
Masaryk TJ, Boumphrey F, Modic MT, Tamborrello C, Ross JS, Brown MD (1986) Effect of chemonucleolysis demonstrated by MR imaging. J Comput Assist Tomogr 10:917–923
Mikhael MA, Ciric IS, Kudruna JC, Hindo WA (1985) Recognition of lumbar disc disease with magnetic resonance imaging. Comput Radiol 9:213–222
Modic MT, Pavlicek W, Weinstein MA, Boumphrey F, Ngo F, Hardy R, Duchesneau PM (1984) Magnetic resonance imaging of intervertebral disk disease. Radiology 152:103–111
von Nicolas V, Krahe T, Dewes W, Venbrocks R, Steudel A, Harder T (1987) MR-Tomographie zur Therapiekontrolle nach Chemonukleolyse. Fortschr Röntgenstr 147:537–542
Szypryt EP, Gibson MJ, Mulholland RC, Worthington BS (1987) The long-term effect of chemonucleolysis on the intervertebral disc as assessed by magnetic resonance imaging. Spine 12:707–711
Venbrocks R, Nicolas V, Ruther W, Clauss G (1988) Die Einsatzmöglichkeit der Kernspintomographie bei der lumbalen Chemonukleolyse. Z Orthop 126:190–194
Brandner ME (1972) Normal value of the vertebral body and intervertebral disk index in adult. Am J Roentgenol 114:411–414
Wiltse LL, Winter RB (1983) Terminology and measurement of spondylolisthesis. J Bone Joint Surg [Am] 65:768–772
Brown MD, Tompkins JS (1989) Pain response post-chemonucleolysis or disc excision. Spine 14:321–326
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Kato, F., Mimatsu, K., Kawakami, N. et al. Changes seen on magnetic resonance imaging in the intervertebral disc space after chemonucleolysis: a hypothesis concerning regeneration of the disc after chemonucleolysis. Neuroradiology 34, 267–270 (1992). https://doi.org/10.1007/BF00588178
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DOI: https://doi.org/10.1007/BF00588178