Wehling P, Schulitz K P, Molsberger A
Orthopädische Klinik der Universität Düsseldorf.
Neurochirurgia (Stuttg). 1989 May;32(3):72-6. doi: 10.1055/s-2008-1054008.
The clinical deterioration in a patient after chemonucleolysis with chymopapain is described in a case report. Experiments were carried out, to receive a proper understanding of possible diagnostic and therapeutic approaches. The paper discusses the pathophysiology of these complications from the view-points of morphology and function. In the important early differential diagnosis between sequestration and neurotoxic complication, magnetic resonance tomography and possibly also spinally evoked nerve potentials play an important role. If a sequester has formed, immediate surgery is imperative, whereas in neurotoxic complication high dosage level cortisone treatment must be performed.
一篇病例报告描述了木瓜凝乳蛋白酶化学髓核溶解术后患者的临床病情恶化情况。进行了相关实验，以便正确理解可能的诊断和治疗方法。本文从形态学和功能的角度讨论了这些并发症的病理生理学。在椎间盘突出与神经毒性并发症的重要早期鉴别诊断中，磁共振断层扫描以及可能的脊髓诱发电位起着重要作用。如果形成了椎间盘突出，必须立即进行手术，而对于神经毒性并发症，则必须进行高剂量的皮质类固醇治疗。
