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Related Experiment Videos

Chymopapain chemonucleolysis: CT changes after treatment.

L R Gentry, P A Turski, C M Strother

    AJR. American Journal of Roentgenology
    |August 1, 1985
    PubMed
    Summary

    Chymopapain chemonucleolysis for lumbar disk herniation shows subtle CT changes early on. Disk size reduction and vacuum phenomenon become more apparent by 6 months, correlating with clinical improvement.

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    Area of Science:

    • Neurosurgery
    • Radiology
    • Orthopedics

    Background:

    • Chymopapain chemonucleolysis is a common treatment for lumbar disk herniation.
    • Patients not responding to treatment require reevaluation, necessitating understanding of post-treatment CT changes.

    Purpose of the Study:

    • To prospectively evaluate temporal changes on computed tomographic (CT) scans after chymopapain chemonucleolysis.
    • To correlate CT findings with clinical outcomes in patients treated for lumbar disk herniation.

    Main Methods:

    • Prospective CT evaluation of 29 interspaces in 26 patients undergoing chemonucleolysis.
    • Serial CT scans performed at routine follow-up intervals (6 weeks and 6 months).
    • Assessment of changes in disk herniation size, location, shape, homogeneity, and density.

    Main Results:

    • At 6-week follow-up, CT changes were uncommon despite clinical success in most patients.
    • Vacuum phenomenon and slight disk size reduction were the most frequent 6-week CT findings.
    • By 6 months, 59.1% of interspaces showed decreased disk herniation size, and 22.7% exhibited vacuum phenomenon.

    Conclusions:

    • Early sciatica improvement after chemonucleolysis may occur without immediate CT size changes, possibly due to disk-space narrowing.
    • Continued clinical improvement correlates with decreased disk height and reduced disk protrusion size on CT scans.

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