Lumbar chymopapain nucleolysis
1Department of Neurological Surgery, University of Wisconsin Medical School and Clinical Science Center, Madison 53792, USA.
Abstract:
Chemonucleolysis with chymopapain is indicated in the majority of patients who are candidates for surgery for intractable sciatica due to herniated nucleus pulposus. It is safer, as effective, and cheaper than standard surgical discectomy, providing that patients are well selected and the procedure is properly performed. Because the indication for chemonucleolysis is not limited to contained discs, it has proved to be more effective than percutaneous discectomy. At present, of all percutaneous methods, lumbar chymopapain nucleolysis is the only procedure that has withstood the test of time. It is an attractive alternative to surgical discectomy and should be presented for consideration to patients who meet the criteria for the procedure.
Related Concept Videos
Nucleotide Excision Repair
Lampbrush Chromosomes
LBCs are made up of two pairs of conjugating homologous chromatids. Each chromatid consists of alternatively positioned regions of condensed-inactive chromatin and loosely placed-active side loops, which can be contracted and extended. The loops resemble the...
Long-patch Base Excision Repair
Restarting Stalled Replication Forks
The Nucleolus
Nucleotide Excision Repair
Cells are regularly exposed to mutagens—factors in the environment that can damage DNA and generate mutations. UV radiation is one of the most common mutagens and is estimated to introduce a significant number of changes in DNA. These include bends or kinks in the structure, which can block DNA replication or transcription. If these errors are not fixed, the damage can cause mutations, which in turn can result in cancer or disease depending on which sequences are...


