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Related Experiment Videos

Chymopapain. A 10-year, double-blind study.

W J Gogan1, R D Fraser

  • 1Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, South Australia.

Spine
|April 1, 1992
PubMed
Summary
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Chymopapain injections significantly improved sciatica outcomes over 10 years compared to saline placebo. This treatment reduced the need for laminectomy and showed sustained therapeutic effects for lumbar disc herniation.

Area of Science:

  • Neurosurgery
  • Pain Management
  • Pharmacology

Background:

  • Sciatica resulting from lumbar intervertebral disc herniation is a common cause of low back pain and disability.
  • Conservative treatments often have limited long-term efficacy, necessitating evaluation of alternative therapeutic options.

Purpose of the Study:

  • To evaluate the long-term (10-year) efficacy and safety of intradiscal chymopapain compared to normal saline in patients with sciatica due to lumbar disc herniation.

Main Methods:

  • A randomized, double-blind study involving 60 patients with sciatica.
  • Patients were allocated to receive either intradiscal chymopapain (30 patients) or intradiscal normal saline (30 patients).
  • Outcomes were assessed at 10 years using patient-reported success rates, need for laminectomy, and blinded independent observer assessments.

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Main Results:

  • A significantly higher proportion of chymopapain recipients (80%) reported successful treatment compared to the saline group (34%) (P = 0.0006).
  • Laminectomy was required less frequently in the chymopapain group (20%) versus the saline group (47%) (P = 0.028).
  • Blinded observers rated 77% of chymopapain patients as moderately or significantly improved, compared to 38% in the saline group (P = 0.004).

Conclusions:

  • Intradiscal chymopapain demonstrates a sustained and significant therapeutic benefit for sciatica caused by lumbar intervertebral disc prolapse over a 10-year period.
  • Chymopapain treatment is associated with a reduced need for subsequent surgical intervention (laminectomy).