[Results of treatment after chemonucleolysis with reference to a special rehabilitation program]

Between January 1985 and March 1987, the authors used chemonucleolysis to treat 66 patients. Patients were observed for an average of 18.2 months. Clinical and radiological follow-up examinations were performed and the results compared with those of other authors. In the present study, particular attention was paid to a program of physiotherapy which used Brunckow's modified lifting exercises. Compared with other follow-up studies, the results of treatment using this form of chemonucleolysis therapy were in the top third. Chemonucleolysis is better for treating sciatica than lumbago. Persistent lumbago can be improved successfully if subsequent physiotherapy is rigidly adhered to. Stabilization through Brunckow's modified lifting exercises is especially suitable for this purpose. There is no correlation between the alteration in the height of the intervertebral space and the clinical picture. A measurement of disk slackness does not allow any prognosis as regards success of treatment. Results have shown that a high degree of success can only be achieved where diagnosis is accurate. Where lumbago has been resistant to therapy for a long time, chemonucleolysis should be prescribed with caution.