Chymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients

The results of chemonucleolysis in 48 patients with lumbar disc disease revealed marked improvement in 58%, slight improvement in 23%, and no improvement in 19%. Serious anaphylactic reactions occurred in two patients. These results and those of other neurosurgical and orthopaedic studies are summarized and compared with the 70% improvement rate obtained with a placebo in a recent double blind controlled cooperative study. Only those few investigators participating in the double blind study are now permitted to use intradiscal chymopapain. It is concluded that the ultimate place of chemonucleolysis, if any, in the treatment of ruptured lumbar discs remains to be determined.