Magnetic resonance imaging before chemonucleolysis for lumbar disc prolapse

✍ Scribed by H. S. Gosal; D. J. Harrison

• Publisher: Springer
• Year: 1995
• Tongue: English
• Weight: 863 KB
• Volume: 4
• Category: Article
• ISSN: 0940-6719
• DOI: 10.1007/bf00303411

✦ Synopsis

Chemonucleolysis is an established non-operative treatment of a prolapsed symptomatic lumbar disc. It was introduced as a form of treatment in the early 1960s by Smith [18]. One of the main causes of failure is the difficulty in pre-operative assessment of a contained disc prolapse. Reducing failure rates is very important for the morale of surgeon and patient alike. We investigated 58 patients with magnetic resonance imaging (MRI) to select those with a contained protrusion prior to chemonucleolysis. Per-operative discography confirmed contained protrusion in 96.5% (56/58) of cases, increasing the specificity of selection. At 6 months post chemonucleolysis 86% of our patients were asymptomatic. We would commend MRI as the investigation method of choice prior to chemonucleolysis for a prolapsed symptomatic lumbar disc, thus avoiding separate diagnostic discography, thereby reducing inconvenience to the patient and wastage of prepared chymopapain.