title: Chemonucleolysis: the state of the art.
abstract: This review presents the history of chemonucleolysis, the techniques, indications, contraindications, and complications. Presenting an historical overview and comparison of success rates with surgical discectomy may provide a fresh understanding of the controversy surrounding chemonucleolysis and establish its efficacy in relation to more invasive treatments. A review of the literature from 1973 through 1998 for chemonucleolysis, open discectomy, and microdiscectomy provided published success rates for these procedures, and a mean rate with standard deviation was determined. In the experience and opinion of the authors, chemonucleolysis remains a viable alternative for patients who have exhausted all conservative means of treatment. Proper patient selection leads to success rates comparable to open discectomy and microdiscectomy.
authors.affiliation: Alamo Bone and Joint Clinic, San Antonio, Texas, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Simmons
authors.forename: E J
authors.initials: EJ
authors.lastname: Nordby
authors.forename: A G
authors.initials: AG
authors.lastname: Hadjipavlou
mesh_terms: D002917:Chymopapain / Q000627:therapeutic use; D000075202:Contraindications; D017586:Diskectomy / Q000379:methods; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000009:adverse effects / Q000379:methods / Q000639:trends*; D053685:Laser Therapy; D008866:Microsurgery; D009985:Orthopedics / Q000379:methods; D018579:Patient Selection
chemical_list: D002917:Chymopapain