The increased signal intensity at the vertebral body endplates after chemonucleolysis demonstrated by magnetic resonance imaging

Spine (Phila Pa 1976). 1993 Nov;18(15):2276-81. doi: 10.1097/00007632-199311000-00023.

Abstract

Changes in signal intensity observed by magnetic resonance imaging in the contiguous end plates of injected discs after chemonucleolysis over a period of 2 years in 28 patients were evaluated. These changes appeared to be of two types; a transiently increased signal intensity on T2-weighted images, and a progressively increased signal intensity on T1-weighted images with isointense or hyperintense signal on T2-weighted images. The former appeared within three months and disappeared within 2 years. This change was observed in six patients (21%), whose mean age was higher than that of the other patients. This change correlated with the preinjection state of the affected disc. The latter appeared after 2 years and was accompanied by sclerotic changes on roentgenograms. These changes were observed in five patients (18%). The discs, of which the contiguous end plates showed these changes, did not recover the decreased nuclear signal intensity in four patients. These changes are considered to be a sign of degenerative spondylosis in the treated segment.

MeSH terms

  • Adult
  • Chymopapain / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc / pathology*
  • Intervertebral Disc Chemolysis*
  • Intervertebral Disc Displacement / diagnosis
  • Intervertebral Disc Displacement / epidemiology
  • Intervertebral Disc Displacement / therapy*
  • Lumbar Vertebrae / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Spinal Osteophytosis / diagnosis
  • Time Factors

Substances

  • Chymopapain