Biomaterial Database

Chemonucleolysis. Current status and future outlook. 1986

J C Sutton

Chemonucleolysis is the most selective and least invasive technique available for the treatment of lumbar disc herniations which have failed to respond to conservative therapy. The technique of lateral discography is extremely exacting and should only be carried out by skilled surgeons who are highly trained in the management of lumbar disc disease. The risk of anaphylaxis following the injection of Chymopapain has been greatly reduced by premedicating patients with histamine I and histamine II receptor antagonists. Severe neurological complications are seen in 0.027% of cases treated. Factors contributing to this serious complication are discussed in detail. As with any surgical procedure patient selection is the most critical factor when classifying results following this form of therapy. When chemonucleolysis is reserved for patients who have sciatica as their major complaint, who demonstrate marked objective findings of nerve root compression, and have a posterolateral disc herniation confirmed by water soluble myelography or CAT scan, over 90% of these patients will be spared a surgical procedure.

UI	MeSH Term	Description	Entries
D007404	Intervertebral Disc Chemolysis	The dissolving of the NUCLEUS PULPOSUS, the semi-gelatinous tissue of a displaced INTERVERTEBRAL DISC. It is usually achieved by the direct injection of a proteolytic enzyme, especially CHYMOPAPAIN, into the herniated disc.	Chemolysis, Intervertebral Disk,Chemonucleolysis,Discolysis,Intervertebral Disk Chemolysis,Nucleolysis, Intervertebral Disk,Chemolysis, Intervertebral Disc,Nucleolysis, Intervertebral Disc,Chemolyses, Intervertebral Disc,Chemolyses, Intervertebral Disk,Chemonucleolyses,Discolyses,Intervertebral Disc Chemolyses,Intervertebral Disc Nucleolyses,Intervertebral Disc Nucleolysis,Intervertebral Disk Chemolyses,Intervertebral Disk Nucleolyses,Intervertebral Disk Nucleolysis,Nucleolyses, Intervertebral Disc,Nucleolyses, Intervertebral Disk
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
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
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005544	Forecasting	The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.	Futurology,Projections and Predictions,Future,Predictions and Projections
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000758	Anesthesia	A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.