Chemonucleolysis in the management of lumbar disc disease. A minimum six-year follow-up evaluation. 1986

J C Sutton

Of 208 chemonucleolysis procedures performed between April 1973 and June 1978, 189 (91%) were available for follow-up evaluation by comprehensive questionnaire after six to 11.2 years. Pain relief, activity level, and personal satisfaction are considered in patients otherwise eligible for discectomy. The procedures were done under general anesthesia with 18-gauge single needle technique using biplane image intensification and routine discography prior to Discase injection. Seventy-nine percent of patients were satisfied with their results, 85% males and 65% females. Sixty-two percent of workman's compensation patients and 57% of patients previously treated by laminectomy had a satisfactory result. Ninety-five percent of patients had disc space narrowing postoperatively. Complications were few and of no lasting concern. Of the failures, 12.7% had laminectomies within 18 months of injection while 9.5% had a satisfactory result for at least two years. Disc reexpansion was demonstrated after postinjection narrowing in 14% of 58 cases roentgenographically evaluated, including patients of the 2nd, 3rd, and 4th decade of life. Recurrence rate in the total series was 9.5%. Chemonucleolysis is the least traumatic invasive procedure capable of removing the nucleus pulposus and is most effective when used in the treatment of lumbar disc herniation with objective signs of nerve root compression. In this series, approximately 80% of patients were spared open surgery.

UI MeSH Term Description Entries
D007405 Intervertebral Disc Displacement An INTERVERTEBRAL DISC in which the NUCLEUS PULPOSUS has protruded through surrounding ANNULUS FIBROSUS. This occurs most frequently in the lower lumbar region. Disc Herniation,Disc Protrusion,Disc, Herniated,Disk Herniation,Disk Protrusion,Disk, Herniated,Intervertebral Disc Herniation,Intervertebral Disc Protrusion,Intervertebral Disk Displacement,Intervertebral Disk Herniation,Intervertebral Disk Protrusion,Prolapsed Disk,Protruded Disc,Protruded Disk,Slipped Disk,Disk Prolapse,Herniated Disc,Herniated Disk,Prolapsed Disc,Slipped Disc,Disc Displacement, Intervertebral,Disc Herniations,Disc Protrusion, Intervertebral,Disc Protrusions,Disc Protrusions, Intervertebral,Disc, Prolapsed,Disc, Protruded,Disc, Slipped,Discs, Protruded,Disk Displacement, Intervertebral,Disk Herniations,Disk Prolapses,Disk Protrusion, Intervertebral,Disk Protrusions,Disk, Prolapsed,Disk, Protruded,Disk, Slipped,Herniated Discs,Herniated Disks,Herniation, Disc,Herniation, Disk,Herniation, Intervertebral Disc,Herniation, Intervertebral Disk,Intervertebral Disc Displacements,Intervertebral Disc Herniations,Intervertebral Disc Protrusions,Intervertebral Disk Displacements,Intervertebral Disk Herniations,Intervertebral Disk Protrusions,Prolapse, Disk,Prolapsed Discs,Prolapsed Disks,Prolapses, Disk,Protruded Discs,Protruded Disks,Protrusion, Disc,Protrusion, Disk,Protrusion, Intervertebral Disc,Protrusion, Intervertebral Disk,Protrusions, Intervertebral Disk,Slipped Discs,Slipped Disks
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002170 Canada The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002917 Chymopapain A cysteine endopeptidase isolated from papaya latex. Preferential cleavage at glutamic and aspartic acid residues. EC 3.4.22.6. Chemolase,Chymodiactin,Chymopapain A,Chymopapain B,Discase
D003258 Consumer Behavior Behavior associated with the procurement of goods, services, or experiences. Consumer Preference,Consumer Satisfaction,Behavior, Consumer,Behaviors, Consumer,Consumer Behaviors,Consumer Preferences,Preference, Consumer,Preferences, Consumer,Satisfaction, Consumer

Related Publications

J C Sutton
December 1986, Journal of neurosurgery,
J C Sutton
September 2015, European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society,
J C Sutton
May 1986, Clinical orthopaedics and related research,
J C Sutton
July 1983, The Orthopedic clinics of North America,
J C Sutton
March 1985, British journal of sports medicine,
J C Sutton
December 1967, Connecticut medicine,
Copied contents to your clipboard!