[Long-term changes in proton spin tomography following chemonucleolysis].
6.5 years after lumbar chemonucleolysis (CNL) we examined 40 patients by MRI. All MRI studies were performed by a 1.0 tesla MRI. We documented the height of the discs, the chondrosis, the intradiscal MRI signal, as well as the intraosseous signal within the vertebral bodies (end plate reaction). Preoperative MRI studies (Tvor) and/or postoperative MRI studies within the first postoperative year (T1) of 18 patients were available. We found an overall reduction of the sagittal disc height of 26%. This reduction was 19% in the male patients and 45% in the female patients (p < 0.02). Comparing the T1-studies with the T6.5-studies, we could still reveal a proceeded reduction of 13%. In those patients who underwent three MRI studies, there was a reduction of 20% between Tvor and T1. Among one half of the patients we found a further decrease in disc height of 15% between T1 and T6.5, whereas the other half showed an increasing disc volume of 15%. At time of follow up (T6.5) all treated discs showed a reduced MRI signal (STIR) within the disc. The signal further decreased comparing the MRI signal (STIR) preoperatively with the follow up evaluation in 64.3% of the cases. However, we found an increase of the signal in 70% of the cases between T1 and T6.5. 6.5 years after CNL we documented an end plate reaction in almost 70% of all patients. There was no correlation between end plate reaction and age of the patients, level of CNL, amount of injected chymopapain or the clinical outcome.
Jerosch
J
J
Klinik und Poliklinik für Allgemeine Orthopädie, Westfälische Wilhelms-Universität Münster.
Castro
W H
WH
Halm
H
H
Meyer
M
M
Assheuer
J
J
D000293:Adolescent; D000328:Adult; D002917:Chymopapain / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007404:Intervertebral Disc Chemolysis; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
D002917:Chymopapain
Langzeitveränderungen in der Kernspintomographie nach Chemonukleolyse.