Chemonucleolysis or discectomy? Results of a randomized multicentre trial in patients with a herniated lumbar intervertebral disc (a preliminary report).
A randomized trial was carried out to compare the results of discectomy and chemonucleolysis in 151 patients, suffering from lumbar disc herniation L4-L5 or L5-S1. All patients fulfilled strict entry criteria. Seventy eight patients underwent surgical discectomy, 73 were treated with chemonucleolysis. Within one year of follow-up 18 patients (25%) required surgery after chemonucleolysis, whereas 2 patients (3%) in the surgery group underwent re-operation. Increase of radicular pain within 30 days after treatment was encountered in 16 patients (22%) in the chemonucleolysis group, as compared to none in the surgery group. The results of open surgery after preceding chemonucleolysis was successful in 44% and unsuccessful in 56%. The final result of chemonucleolysis, including second treatment, was still slightly less favourable (73%) the result of primary surgery (79%).
van Alphen
H A
HA
Department of Neurosurgery, Vrije Universiteit, Amsterdam, The Netherlands.
Braakman
R
R
Berfelo
M W
MW
Broere
G
G
Bezemer
P D
PD
Kostense
P J
PJ
D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007404:Intervertebral Disc Chemolysis / Q000009:adverse effects; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications; D011897:Random Allocation