[Long-term result of lumbar disk chemonucleolysis (a 8-12 years follow-up)]. 1994

F Lecuire, and Z Jaffar-Bandjee, and M Basso, and L Sorba, and M Honoré, and J Rebouillat
Service de Chirurgie orthopédique, Hôpital Renée Sabran, Giens, Hyères.

BACKGROUND This study is an attempt to assess the effects of chemonucleolysis over an extended period of time (8 to 12 years follow-up). METHODS From 1981 to 1985, chemonucleolysis using Chymopapain was performed on 134 patients for the relief of radicular pain from herniated lumbar discs. The long term results were evaluated in 110 patients. This represented a total follow-up rate of 82 per cent. 24 patients were lost to follow-up. RESULTS Of the 110 patients who had been reviewed at 8 to 12 years follow-up: 76 patients did not need other treatment than the initial chemonucleolysis. The results were excellent or good in 69 patients (63 per cent) and fair in 7 patients (6 per cent). 34 required surgery (31 per cent). This rate does not reflect the real failure rate of chemonucleolysis: 7 patients underwent early surgery and corresponded with the beginning of our experience with chemonucleolysis. 7 patients needed surgical treatment after a successful initial result for two to nine years. The real failure rate concerned 19 patients (17 per cent). These patients did not have any pain relief following chemonucleolysis. Surgical treatment was undertaken on the average 18 months after chemonucleolysis. One patient had suffered from radicular pain 6 years following the first chemonucleolysis. In this case, iterative chemonucleolysis had been done on the same lumbar level. It was effective on the radicular pain but not on the back pain. Chemonucleolysis had been effective in 70 per cent of the patients. CONCLUSIONS Our study showed that the long term results following chemonucleolysis were effective and the mortality rate was low. (No severe complication in this study). This study is compared with the literature, studying the results of chemonucleolysis patients, or comparing patients treated by chymopapain or surgical discectomy. CONCLUSIONS We conclude that chemonucleolysis is an effective and safe method for treating sciatica by herniated lumbar discs.

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
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
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
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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