Lütten C, Lorenz H, Schröder J
I. Orthopädische Klinik, Allgemeines Krankenhaus Barmbek.
Neurochirurgia (Stuttg). 1990 Nov;33(6):190-4. doi: 10.1055/s-2008-1053582.
Between January 1985 and March 1987, the authors used chemonucleolysis to treat 66 patients. Patients were observed for an average of 18.2 months. Clinical and radiological follow-up examinations were performed and the results compared with those of other authors. In the present study, particular attention was paid to a program of physiotherapy which used Brunckow's modified lifting exercises. Compared with other follow-up studies, the results of treatment using this form of chemonucleolysis therapy were in the top third. Chemonucleolysis is better for treating sciatica than lumbago. Persistent lumbago can be improved successfully if subsequent physiotherapy is rigidly adhered to. Stabilization through Brunckow's modified lifting exercises is especially suitable for this purpose. There is no correlation between the alteration in the height of the intervertebral space and the clinical picture. A measurement of disk slackness does not allow any prognosis as regards success of treatment. Results have shown that a high degree of success can only be achieved where diagnosis is accurate. Where lumbago has been resistant to therapy for a long time, chemonucleolysis should be prescribed with caution.
1985年1月至1987年3月期间，作者采用化学溶核术治疗了66例患者。患者平均接受了18.2个月的观察。进行了临床和影像学随访检查，并将结果与其他作者的结果进行了比较。在本研究中，特别关注了一项采用布伦科夫改良提升运动的物理治疗方案。与其他随访研究相比，采用这种化学溶核疗法的治疗结果处于前1/3。化学溶核术治疗坐骨神经痛比腰痛效果更好。如果严格坚持后续的物理治疗，持续性腰痛可以成功改善。通过布伦科夫改良提升运动实现的稳定尤其适用于此目的。椎间隙高度的改变与临床表现之间没有相关性。椎间盘松弛度的测量无法对治疗成功与否进行任何预后判断。结果表明，只有在诊断准确的情况下才能取得高度成功。对于长期对治疗有抵抗性的腰痛，应谨慎开具化学溶核术的处方。
