title: Morphological alterations of the degenerated lumbar disc following chemonucleolysis with chymopapain.
abstract: Lumbar disc tissue from 10 patients who had previously undergone chemonucleolysis without success was studied by light and scanning electron microscopy. Seven patients had a sequestrated disc; three had large protrusions. As a control, material from 10 patients subjected to disc surgery without previous chemonucleolysis was studied in the same way. The control discs revealed the characteristic signs of degeneration: alteration of the collagen, microcystic areas, and giant chondromas. Changes following chemonucleolysis were restricted exclusively to the ground substance and characterized by a marked loss of basophilia in the cartilage matrix. There was no involvement of the anulus fibrosus, cartilage plate, or bone. Following chymopapain administration, scanning electron microscopy showed a naked collagen network devoid of ground substance.
mesh_terms: D000328:Adult; D001491:Basophils / Q000032:analysis; D002356:Cartilage / Q000648:ultrastructure; D002917:Chymopapain / Q000627:therapeutic use*; D010450:Endopeptidases / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000648:ultrastructure*; D007405:Intervertebral Disc Displacement / Q000188:drug therapy / Q000473:pathology*; D008161:Lumbosacral Region; D008297:Male; D008853:Microscopy; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D013122:Spinal Diseases / Q000188:drug therapy / Q000473:pathology*
chemical_list: D010450:Endopeptidases; D002917:Chymopapain