Herron L D, Turner J
Central Coast Spine Institute, San Luis Obispo, CA 93401.
Clin Orthop Relat Res. 1987 Nov(224):125-33.
A revised objective rating system, previously found useful for patient selection for lumbar laminectomy and discectomy, was evaluated in patient selection for chemonucleolysis by intradiscal chymopapain. Based on the severity of findings within each of four categories (neurologic signs, root tension signs, myelogram or computed tomography (CT) findings, and psychosocial environment), numerical scores are derived. A maximum score of 25 points is available in each of four categories for a total of 100 points. The objective rating score was determined in a series of 101 patients prior to treatment of lumbar disc herniation by chemonucleolysis. The patients were evaluated at least one year after injection. The objective rating score was predictive of the result of chemonucleolysis, and was even more strongly predictive of the ultimate surgical outcome, which included the results in 22 patients who were treated by laminectomy after chemonucleolysis failure.
一种修订后的客观评分系统，先前发现对腰椎椎板切除术和椎间盘切除术的患者选择有用，现对木瓜凝乳蛋白酶化学髓核溶解术的患者选择进行评估。根据四个类别（神经体征、神经根张力体征、脊髓造影或计算机断层扫描（CT）结果以及社会心理环境）中每个类别的发现严重程度得出数值分数。四个类别中每个类别最高可得25分，总计100分。在101例腰椎间盘突出症患者接受化学髓核溶解术治疗前确定了客观评分。患者在注射后至少一年进行评估。客观评分可预测化学髓核溶解术的结果，对最终手术结果的预测性更强，最终手术结果包括22例化学髓核溶解术失败后接受椎板切除术的患者的结果。
