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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...

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Related Experiment Video

Updated: Jun 4, 2026

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
05:42

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation

Published on: April 7, 2023

Chemonucleolysis as treatment for herniated lumbar disc.

D I Alexander

    Canadian Family Physician Medecin De Famille Canadien
    |January 29, 2011
    PubMed
    Summary

    Chemonucleolysis using chymopapain offers an alternative to surgery for herniated disc pain. Proper patient selection and technique are crucial for successful outcomes, as it is not a conservative treatment.

    Area of Science:

    • Neurosurgery
    • Pain Management
    • Enzymatic Therapy

    Background:

    • Herniated discs are a common cause of low back pain and a frequent indication for surgical intervention.
    • Chemonucleolysis with chymopapain presents a non-surgical alternative for managing sciatic pain stemming from disc herniation.

    Purpose of the Study:

    • To outline the critical criteria for patient selection in chemonucleolysis.
    • To highlight the importance of patient selection due to the specific efficacy of chymopapain.
    • To detail contraindications and emphasize the technique's exacting nature.

    Main Methods:

    • Review and presentation of five key selection criteria for chemonucleolysis.
    • Identification of absolute contraindications, including allergies, cauda equina risk, pregnancy, and specific disc pathologies.

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  • Emphasis on reserving chemonucleolysis for patients unresponsive to conservative treatments.

    • Main Results:

    • Proper patient selection is paramount for the efficacy of chemonucleolysis.
    • Chemonucleolysis is indicated only for specific herniated disc cases unresponsive to conservative care.
    • Several contraindications must be strictly adhered to, including patient age and disc sequestration.

    Conclusions:

    • Chemonucleolysis with chymopapain is an effective alternative to surgery for select patients with herniated discs and sciatic pain.
    • Strict adherence to selection criteria and contraindications is essential for patient safety and treatment success.
    • The procedure demands specialized surgical expertise and concentrated experience for optimal results.