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Related Experiment Videos

Chymopapain in perspective.

E J Dabezies, C Beck, H Shoji

    Clinical Orthopaedics and Related Research
    |May 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Chemonucleolysis with chymopapain offers effective treatment for herniated nucleus pulposus syndrome, with good to excellent long-term results in over half of patients. This safe and reproducible procedure shows promising outcomes for spinal disc conditions.

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    Area of Science:

    • Neurosurgery
    • Orthopedic Surgery
    • Minimally Invasive Spine Procedures

    Background:

    • Herniated nucleus pulposus syndrome is a common cause of low back pain.
    • Chemonucleolysis offers a less invasive alternative to discectomy.
    • Chymopapain has been used to enzymatically digest nucleus pulposus tissue.

    Purpose of the Study:

    • To evaluate the efficacy and safety of chemonucleolysis with chymopapain for herniated nucleus pulposus syndrome.
    • To assess long-term outcomes and potential adverse effects of the procedure.

    Main Methods:

    • A cohort of 359 patients with herniated nucleus pulposus syndrome underwent chemonucleolysis with chymopapain.
    • Patients were followed for a minimum of six months, with a subset observed for an average of ten years.

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  • A premedication regimen including dexamethasone, diphenhydramine, and cimetidine was administered.

    • Main Results:

    • Good to excellent results were achieved in 71% of patients at six months.
    • Long-term follow-up (average 10 years) showed favorable results in 86.6% of patients.
    • 58% of all patients experienced good to excellent long-term outcomes.
    • Disc space narrowing averaged 2 mm without impacting results.
    • No cases of anaphylaxis were reported with the premedication protocol.

    Conclusions:

    • Chemonucleolysis with chymopapain is a safe, reproducible, and effective treatment for herniated nucleus pulposus syndrome.
    • The procedure demonstrates favorable short- and long-term outcomes.
    • A premedication regimen effectively prevents anaphylaxis, enhancing procedural safety.