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Related Experiment Videos

Pain response post-chemonucleolysis or disc excision.

M D Brown1, J S Tompkins

  • 1Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Florida.

Spine
|March 1, 1989
PubMed
Summary

Surgery provided the lowest pain perception for patients with lumbar disc displacement after conservative care failed. Enzyme injections, including collagenase and chymopapain, resulted in higher reported pain levels.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Biochemistry

Background:

  • Lumbar disc displacement often requires advanced treatment when conservative care fails.
  • Patient self-selection into treatment groups introduces potential bias.
  • Understanding differential enzyme efficacy is crucial for targeted therapies.

Purpose of the Study:

  • To compare the efficacy of collagenase, chymopapain, and surgery for lumbar disc displacement.
  • To evaluate patient pain perception and treatment outcomes post-intervention.
  • To explore biochemical explanations for observed pain responses.

Main Methods:

  • Prospective study of 85 patients with lumbar disc displacement.
  • Self-selected treatment groups: collagenase, chymopapain, or surgery.

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  • Data collection: pain levels, physical exams, hospital stay, return to activities (3-month follow-up).

    • Main Results:

    • Surgical group reported statistically lowest post-treatment pain perception.
    • Enzyme-injected groups (collagenase, chymopapain) reported higher pain.
    • Collagenase group reported more pain than chymopapain group.
    • Surgery yielded the most satisfactory outcomes at 3 months.

    Conclusions:

    • Surgical intervention appears most effective for pain reduction and satisfactory outcomes in this patient cohort.
    • Enzyme therapy efficacy may differ, with chymopapain potentially offering better pain relief than collagenase.
    • Biochemical interactions of enzymes with connective tissue matrix may explain differential pain responses.