Discography / Chemonucleolysis - Simon Richards 31/5/2001

BACKGROUND

Discography is the injection of contrast material into the intervertebral disc space looking for internal derangement, as well as seeing if the injection reproduces the patients characteristic pain, i.e a provocative discography. Subjective test.

Chymo developed in 1963 ( Lyman Smith ). It is the chemical hydrolysis of the nucleus polposus with chymopapain. Approved by the FDA in 1982

Authors	O.Losti, R.D.Fraser
Title	MRI and Discography of annular tears and intervertebral disc degeneration.
Reference	JBJS. Br. 1992:74-B:431 - 435
Summary	Prospective trial. 33pts with 114 discs. Mean age 35yrs. T2 MRI looking at signal intensity from cental zone of disc. (normal, reduced, abscent) Disco after MRI (normal, tear with no leak, tear with leak, no nucleus) All abnormal MRI had abnormal disco. 33 of 60 normal MRI had abnormal disco.
Critique	Good but small. New MRI techniques probably give better anatomy

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