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Chemonucleolysis. Eight- to ten-year follow-up evaluation
Clinical Orthopaedics and Related Research
|May 1, 1986
Summary
Chymopapain injections offer long-term relief for severe sciatic pain from herniated discs, with over 70% excellent or good results persisting for eight to ten years. Most patients maintained active lifestyles, with low unemployment rates reported.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Pain Management
Background:
- Severe sciatic pain often results from herniated nucleus pulposus.
- Conservative treatments have limitations for persistent pain.
- Chymopapain injection offered an alternative treatment modality.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of chymopapain injection for severe sciatic pain.
- To assess patient outcomes and lifestyle changes over an eight- to ten-year follow-up period.
Main Methods:
- A cohort of 265 patients with severe sciatic pain underwent chymopapain injection.
- Follow-up included one- to two-year examinations and an eight- to ten-year survey.
- Patient outcomes were assessed based on pain levels, functional status, and lifestyle.
Main Results:
- At one to two years, 62.3% of 263 patients showed excellent or good response.
- At eight to ten years, 71.5% of 130 patients reported excellent or good improvement.
- Despite residual pain in 50%, 72% reported active lifestyles, and only 13.1% were unemployed due to back condition.
Conclusions:
- Chymopapain injection provides durable relief for severe sciatic pain associated with herniated nucleus pulposus.
- The positive effects on pain and function generally persist over an eight- to ten-year period.
- Chymopapain injection can significantly improve quality of life and reduce long-term disability.