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[Long-term changes in proton spin tomography following chemonucleolysis]

J Jerosch1, W H Castro, H Halm

  • 1Klinik und Poliklinik für Allgemeine Orthopädie, Westfälische Wilhelms-Universität Münster.

Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|January 1, 1994
PubMed
Summary

Lumbar chemonucleolysis (CNL) led to a 26% average disc height reduction over 6.5 years, with significant differences between sexes. Intradiscal MRI signals decreased, while end plate reactions occurred in nearly 70% of patients.

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Area of Science:

  • Radiology
  • Orthopedic Surgery
  • Biomedical Engineering

Context:

  • Lumbar chemonucleolysis (CNL) is a minimally invasive treatment for discogenic low back pain.
  • Long-term outcomes of CNL, particularly regarding spinal morphology and MRI findings, require further investigation.
  • Magnetic Resonance Imaging (MRI) is crucial for evaluating treatment effects on intervertebral discs and vertebral bodies.

Purpose:

  • To assess the long-term (6.5 years) effects of lumbar chemonucleolysis on disc height, intradiscal MRI signal, and end plate reactions using 1.0 tesla MRI.
  • To compare pre- and post-treatment MRI findings and analyze changes over time.
  • To investigate potential correlations between MRI findings and patient demographics or treatment parameters.

Summary:

  • A 6.5-year follow-up study of 40 patients treated with lumbar chemonucleolysis (CNL) revealed an overall 26% reduction in sagittal disc height, with greater reduction in females (45%) than males (19%).

Related Experiment Videos

  • Continued disc height reduction was observed between 1 and 6.5 years post-treatment (13%).
  • Intradiscal MRI signal (STIR) decreased in most cases by 6.5 years, though some signals increased between 1 and 6.5 years. End plate reactions were present in nearly 70% of patients, unrelated to clinical outcomes or treatment specifics.

    • Impact:

    • Provides crucial long-term data on the structural changes following lumbar chemonucleolysis, informing patient selection and expectations.
    • Highlights sex-specific differences in disc height response to CNL, suggesting potential variations in treatment efficacy.
    • Demonstrates the utility of serial MRI in monitoring the degenerative and reactive changes in the spine after chemonucleolysis.