Chemonucleolysis for sciatica. A critical review.
Intradiscal injection of chymopapain for the treatment of sciatica due to disc herniation has been used for more than 25 years, but is still under debate. We review the indications, complications, and clinical results, and discuss the tissue effects of chymopapain. The results following surgical disc removal versus chymopapain injection indicate that surgery with removal of the disc hernia through a small laminotomy remains the documented treatment of choice for patients with proven disc herniation and sciatica in whom conservative treatment has failed.
Nachemson
A L
AL
Department of Orthopedics, University of Gothenburg, Sahlgren Hospital, Sweden.
Rydevik
B
B
D002917:Chymopapain / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007403:Intervertebral Disc / Q000187:drug effects; D007404:Intervertebral Disc Chemolysis; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D012585:Sciatica / Q000188:drug therapy* / Q000209:etiology
D002917:Chymopapain