title: Repeat chemonucleolysis is safe and effective.
abstract: A review was made of 85 patients who received a second injection of chymopapain because of a recurrent disc herniation between 1980 and 1996. All patients were pretreated for 3 days with H1 and H2 receptor blockers. Immediate sensitivity reactions were not seen. Four Type 1 and one Type 2 reactions were seen after the the second injection. No other complications were seen. In this group of 85 patients, 66 patients received a second injection at the same level as primary treatment after a period of 57.1 months (range, 2-143 months). Two patients were lost to followup. Four patients had surgery, three with good results. Good results and no complications were seen in three patients who had a third chemonucleolysis because of another recurrence after 15, 40, and 56 months, respectively. The remaining 57 patients were interviewed after 64 months (range, 3-143 months). Using the Prolo scale, 51 patients were rated as having excellent or good results, and six patients were rated as having fair or poor results.
authors.affiliation: Department of Orthopaedics, Martini Hospital, Groningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: van de Belt
authors.forename: S
authors.initials: S
authors.lastname: Franssen
authors.forename: R
authors.initials: R
authors.lastname: Deutman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002917:Chymopapain / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007404:Intervertebral Disc Chemolysis; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002917:Chymopapain