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Serum keratan sulphate level following chemonucleolysis
K P Muralikuttan1, I V Adair, G Roberts
1Department of Orthopaedic Surgery, Queen's University of Belfast, Musgrave Park Hospital, United Kingdom.
Spine
|September 1, 1991
Summary
Serum keratan sulphate levels increase after chemonucleolysis, confirming accurate needle placement. However, this biochemical marker does not predict the procedure's clinical outcome for patients with back pain.
Area of Science:
- Biochemistry
- Orthopedic Surgery
- Pain Management
Background:
- Chemonucleolysis accuracy is challenging to assess, especially when patients lack symptom improvement.
- Pre-chemonucleolysis discography carries risks of neurologic complications.
- Biplane fluoroscopy visualization can be suboptimal for confirming needle placement.
Purpose of the Study:
- To investigate serum keratan sulphate levels as a biochemical indicator for confirming accurate needle placement during chemonucleolysis.
- To determine if serum keratan sulphate levels can predict the clinical outcome of chemonucleolysis.
Main Methods:
- Serum keratan sulphate levels were measured in patients undergoing chemonucleolysis.
- Measurements were taken before and at 24 or 48 hours post-procedure.
- Patients were categorized based on symptom improvement.
Main Results:
- Serum keratan sulphate levels significantly increased within 3 days post-chemonucleolysis (P < 0.01).
- The magnitude of the serum keratan sulphate rise did not differ significantly between patients who improved and those who did not (P = 0.35).
Conclusions:
- Serum keratan sulphate level monitoring can confirm accurate needle placement in chemonucleolysis.
- Elevated serum keratan sulphate post-procedure is not predictive of clinical pain relief or treatment success.