Suguro T, Oegema T R, Bradford D S
Clin Orthop Relat Res. 1986 Dec(213):223-31.
Light and electron microscopy were used to demonstrate extensive matrix degradation in a failed chymopapain-treated disc as compared with an untreated degenerative control disc. Both specimens contained viable cells with patches of degenerative cells. There was a loss of disc height in the chymopapain-treated disc, but no improvement of symptoms. These results illustrated that even in well-circumscribed cases with documented disc protrusion into the spinal canal, the disc space narrowing following injection may aggravate the symptoms of nerve root entrapment, especially if a low-grade lateral recess stenosis is associated with the disc protrusion. The persistence or aggravation of symptoms probably is related to these anatomic considerations. The low level of enzyme activity in the injected area may or may not be correlated with the clinical response to treatment.
与未治疗的退变对照椎间盘相比，采用光镜和电镜观察以证实木瓜凝乳蛋白酶治疗失败的椎间盘中存在广泛的基质降解。两个标本均含有存活细胞及散在的退变细胞。木瓜凝乳蛋白酶治疗的椎间盘中存在椎间盘高度丢失，但症状并无改善。这些结果表明，即使在有记录显示椎间盘突入椎管的界限清楚的病例中，注射后椎间盘间隙变窄也可能加重神经根受压症状，尤其是当低度侧隐窝狭窄与椎间盘突出相关时。症状持续或加重可能与这些解剖学因素有关。注射区域的低水平酶活性可能与治疗的临床反应相关，也可能无关。
