[Chemonucleolysis. A therapeutic alternative in extra-canalicular lumbar disk hernias]

Between 1% and 13% of lumbar disk hernias lie in a very lateral position outside the canal. Diagnosis of the disease is based mainly on CT scan with x-ray. Once conservative therapy has failed, surgery has hitherto been the only treatment proposed, but this generally requires sacrifice of an articular mass. The authors report their experience with chemonucleolysis with chymopapain in five patients presenting this type of hernia. Cure was obtained in four cases. The main advantage of the technique is that osteo-articular structures are preserved.