Introduction: This study is an attempt to assess the effects of chemonucleolysis over an extended period of time (8 to 12 years follow-up).
Material And 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.
Discussion: 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.
Conclusion: We conclude that chemonucleolysis is an effective and safe method for treating sciatica by herniated lumbar discs.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Developments and clinical experiences in collagenase chemonucleolysis for lumbar disc herniation: a narrative review.
Front Med (Lausanne)
January 2025
Department of Orthopedic, Dianjiang People's Hospital of Chongqing, Chongqing, China.
Lumbar disc herniation (LDH) affects millions globally, with annual healthcare costs exceeding $100 billion in the United States alone, driving increasing interest in minimally invasive radiological interventions as treatment alternatives. This narrative review examines developments in collagenase chemonucleolysis for LDH, integrating a literature analysis with clinical experience. Key advancements include the transition from single-agent to combination therapies, exploration of diverse injection routes, and the progression from C-arm fluoroscopy to multi-slice CT guidance.
View Article and Find Full Text PDFImmediate effectiveness of condoliase chemonucleolysis for lumbar disc herniation: a comparative study between patients with difficulty walking because of severe leg pain and those who can walk.
Neurosurg Rev
January 2025
Department of Orthopedic Surgery, NHO Osaka Minami Medical Center, Kawachinagano, Osaka, Japan.
Surgery is often the treatment of choice for lumbar disc herniation (LDH) with severe leg pain. This study aimed to investigate the efficacy of Condoliase chemonucleolysis (CC) in patients who were nonambulatory because of severe leg pain. A total of 58 patients who underwent CC for conservative treatment-resistant LDH were included in this study.
View Article and Find Full Text PDFEarly therapeutic efficacy of condoliase chemonucleolysis for lumbar disc herniation.
J Orthop Surg Res
December 2024
Department of Orthopaedic Surgery, Japan Red Cross Aichi Medical Center Nagoya Daini Hospital, Myokencho 2-9, Syowa-Ku, Nagoya, Aichi, 466-8650, Japan.
Background: Low back pain is often caused by lumbar disc herniation (LDH). Treatment of LDH is possible using chemonucleolysis of the nucleus pulposus with condoliase injection. However, onset of the therapeutic effect varies among patients, with improvement from an early stage to 3 months post-injection.
View Article and Find Full Text PDFCollagenase Chemonucleolysis for Treating Cervical Disc Herniation: An Exploratory, Single-Arm, Open-Label, Multicenter Clinical Trial.
Pain Ther
February 2025
Department of Pain, The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zheng Street, Donghu District, Nanchang, 330000, Jiangxi, China.
Introduction: Cervical disc herniation (CDH) is the most common cause of cervical radiculopathy and causes persistent neck pain and neurological deficits. Collagenase chemonucleolysis has been successfully applied to treat lumbar disc herniation, which has a similar pathological mechanism to CDH. However, its application for CDH remains under-researched, and there is an even greater lack of high-quality clinical evidence.
View Article and Find Full Text PDFTransforaminal Endoscopic Lumbar Discectomy versus Coblation Nucleoplasty Combined with Collagenase Chemonucleolysis for Lumbar Disc Herniation with Grade I Degenerative Spondylolisthesis.
Pain Ther
February 2025
Department of Pain Medicine, The First Affiliated Hospital of AnHui Medical University, HeFei, China.
Introduction: To investigate the short-term clinical effect of transforaminal endoscopic lumbar discectomy (TELD) versus coblation nucleoplasty (CN) combined with collagenase chemonucleolysis (CCNL) in the treatment of lumbar disc herniation (LDH) with grade I degenerative spondylolisthesis.
Methods: From January 2019 to December 2020, 60 patients who had LDH with grade I degenerative spondylolisthesis were divided into two groups. Group A adopted TELD while Group B adopted CN combined with CCNL.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!