Update on chymopapain

Chemonucleolysis with chymopapain is accepted by many surgeons as a reasonable alternative to lumbar diskectomy for the treatment of lumbar disk disease. Approximately 70 to 75 per cent of carefully selected patients are successfully treated following this therapy, but extreme care must be exercised for precise needle placement and prompt and vigorous management of major allergic reactions. Methods to avoid major complications and their management, should they occur, are discussed.