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Chemonucleolysis for herniated nucleus pulposus in adolescents
The Journal of Bone and Joint Surgery. American Volume
|December 1, 1985
Summary
Chemonucleolysis, a minimally invasive procedure, was evaluated in 55 adolescents with herniated lumbar discs. While generally safe and effective, 20% of patients did not experience symptom relief and required further surgery.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Pediatric Spine Surgery
Background:
- Herniated lumbar discs are a significant cause of pain in adolescents.
- Conservative management often fails, necessitating alternative treatments.
- Chemonucleolysis offers a less invasive option compared to traditional discectomy.
Purpose of the Study:
- To evaluate the efficacy and safety of chemonucleolysis in an adolescent population.
- To assess long-term outcomes for adolescents undergoing chemonucleolysis for herniated lumbar discs.
Main Methods:
- Fifty-five adolescents (13-19 years) with herniated lumbar discs underwent chemonucleolysis.
- The procedure was performed between 1972 and 1982.
- Patients were selected after failing conservative management.
Main Results:
- One patient experienced a successful anaphylactic reaction.
- Increased back pain was the most common post-injection symptom, managed with medication.
- Eleven out of 55 patients (20%) did not achieve symptom relief and required subsequent discectomy.
Conclusions:
- Chemonucleolysis is a viable alternative for adolescents with herniated lumbar discs unresponsive to conservative care.
- While generally safe, a subset of patients may not benefit and require surgical intervention.
- Long-term follow-up indicates a significant success rate, but careful patient selection is crucial.