Double-blind evaluation of intradiscal chymopapain for herniated lumbar discs. Early results.
The authors report 66 patients with signs, symptoms, and a myelographic abnormality of herniated lumbar disc, who were not responsive to conservative treatment. The discs were injected at random with either chymopapain or a placebo. Neither patient nor surgeon knew which agent was used until after the results had been tabulated. Unless early laminectomy was necessary for intractable pain, all patients were followed for 2 months or more. There was no statistically significant difference in incidence or quality of improvement between the two groups: chymopapain was successful in 58% while placebo was successful in 49% (p = 0.15). Early results from this study indicate that most, if not all, of the putative effectiveness of chemonucleolysis probably derives from a placebo effect.
D000328:Adult; D002917:Chymopapain / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D010450:Endopeptidases / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D007403:Intervertebral Disc; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D010450:Endopeptidases; D002917:Chymopapain