Computed tomography and chymopapain chemonucleolysis: preliminary findings

Area of Science:

• Radiology
• Neurosurgery
• Biochemistry

Background:

• Herniated nucleus pulposus (HNP) is a common cause of low back pain.
• Chymopapain chemonucleolysis is a minimally invasive treatment for HNP.
• Computed tomography (CT) is a valuable imaging modality for evaluating spinal conditions.

Purpose of the Study:

• To evaluate the effect of chymopapain chemonucleolysis on HNP morphology using CT.
• To correlate CT findings with clinical outcomes after chemonucleolysis.

Main Methods:

• Ten lumbar disk levels in nine patients with HNP were examined by CT before and 6 weeks after chymopapain chemonucleolysis.
• Patient selection was based on CT criteria predictive of successful treatment.
• HNP size and attenuation were measured on posttreatment CT scans.

Main Results:

• CT scans demonstrated a 1-3 mm decrease in HNP size at nine of 10 levels.
• Increased HNP attenuation was observed at many levels posttreatment.
• CT findings showed a close correlation with objective clinical outcome parameters.

Conclusions:

• Chymopapain chemonucleolysis effectively reduces HNP size and increases attenuation.
• CT imaging is a useful tool for assessing treatment response to chemonucleolysis.
• Improved imaging findings correlate with positive clinical outcomes in HNP patients.