title: [Late myelopathy after chemonucleolysis. Case report and review of the literature].
abstract: Chemonucleolysis is a debated therapeutic method for herniated lumbar disc. We report a patient who suffered a sequence of characteristic sequels cumulating in late-onset myelopathy with persistent spastic paraplegia, sensory loss below T8 and bladder incontinence. Complications of chemonucleolysis are less frequent as compared to herniated disc surgery, but may cause severe impediment. Serious complications are anaphylactic shock, intracranial or spinal hemorrhage and transverse myelitis. This has to be taken into account for indication and patient information.
authors.affiliation: Neurologische Universitätsklinik, Heidelberg.
authors.forename: P
authors.initials: P
authors.lastname: Haag
authors.forename: K
authors.initials: K
authors.lastname: Münkel
authors.forename: H M
authors.initials: HM
authors.lastname: Meinck
mesh_terms: D002917:Chymopapain / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007404:Intervertebral Disc Chemolysis / Q000009:adverse effects*; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008159:Lumbar Vertebrae / Q000187:drug effects*; D008318:Malpractice / Q000331:legislation & jurisprudence; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010264:Paraplegia / Q000139:chemically induced / Q000175:diagnosis; D012678:Sensation Disorders / Q000139:chemically induced / Q000175:diagnosis; D013118:Spinal Cord Diseases / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D002917:Chymopapain