Chemonucleolysis.
A prospective study of 480 patients who underwent enzymatic dissolution of the nucleus pulposus with chymopapain is reported. Seventy per cent of patients with the clincial criteria for a disc herniation had a favourable response to chemonucleolysis. The commonest cause of failure was persistent back pain. In patients with sequestered discs or lateral recess stenosis surgical intervention was not made more difficult by chemonucleolysis. Those with a previous operation, spinal stenosis or psychogenic components to the disability had very poor results. Complications were few and easily managed.
D000328:Adult; D001416:Back Pain / Q000188:drug therapy; D002917:Chymopapain / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D003877:Dermatitis, Contact / Q000209:etiology; D010450:Endopeptidases / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000187:drug effects*; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008159:Lumbar Vertebrae / Q000187:drug effects*; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D012008:Recurrence; D013122:Spinal Diseases / Q000188:drug therapy*
D010450:Endopeptidases; D002917:Chymopapain