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Intraoperative chemonucleolysis as an adjunct to lumbar discectomy
O Sagher1, T A Szabo, A G Chenelle
1Section of Neurosurgery, University of Michigan Medical Center, USA.
Spine
|September 1, 1995
Summary
This study found chemonucleolysis during lumbar surgery to be safe, with 70% of patients experiencing significant pain relief. The procedure also suggested a reduced rate of recurrent disc herniation in patients with low back pain.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Procedures
Background:
- Chymopapain is an enzyme used for chemonucleolysis.
- This study is the first to report on chymopapain use during open surgery.
Purpose of the Study:
- To assess the safety of lumbar discectomy with chemonucleolysis.
- To evaluate the efficacy of this procedure for low back pain and radicular symptoms.
Main Methods:
- 104 patients with persistent low back pain underwent lumbar discectomy and chymopapain injection.
- Patients were followed for an average of 5 years post-procedure.
- Outcomes measured included pain relief and reoperation rates.
Main Results:
- 70% of patients reported good or excellent pain relief.
- Operative failures requiring reoperation occurred in 9.6% of patients.
- Recurrent disc herniation was observed in 4.8% of reoperations.
Conclusions:
- Lumbar discectomy with chemonucleolysis is a safe procedure.
- Pain relief outcomes are comparable to other published studies.
- The procedure may reduce the incidence of recurrent disc herniation.