Austin R T, Zuk J A
J R Coll Surg Edinb. 1989 Feb;34(1):30-2.
Epidural adhesions were discovered in seven of nine patients undergoing surgery for failed chymopapain chemonucleolysis. Clinically the adhesions were very vascular, prolific and adherent to the nerve root, dura and the porieties. The histological composition was similar to the normal tissues of the epidural space from the post-mortem controls and also to adhesions discovered at surgery in a non-injected patient, except that there was an increase in fibrous tissue, which was poorly cellular. There was no evidence of an inflammatory infiltrate. Such adhesions may partly explain the failure of chemonucleolysis and prejudice the success of surgery by potentiating further adhesion formation.
在接受木瓜凝乳蛋白酶化学髓核溶解术失败而进行手术的9名患者中，有7名发现了硬膜外粘连。临床上，这些粘连血管丰富、增生明显，且附着于神经根、硬脑膜和骨孔。组织学组成与尸检对照的硬膜外间隙正常组织相似，也与未注射患者手术中发现的粘连相似，只是纤维组织有所增加，且细胞较少。没有炎症浸润的证据。此类粘连可能部分解释了化学髓核溶解术的失败，并通过促进进一步粘连形成而影响手术成功率。
