Foot and Ankle International
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Wheeless' Textbook of Orthopaedics

Chemonucleolysis as an alternative to laminectomy for the herniated


lumbar disc. Experience with patients in a private orthopedic practice. Hill-GM; Ellis-EA Alabama Sports Medicine and Orthopaedic Center, Birmingham 35205. Clin-Orthop. 1987 Dec(225): 229-33 Three hundred thirty-five patients with herniated lumbar intervertebral discs were injected with chymopapain. The overall success rate was 76%. The success rate was higher for private insurance patients (89%) than for Worker's Compensation patients (66%). There were no serious complications and patients spent fewer days in the hospital and returned to work faster than patients with laminectomies. Chemonucleolysis is an excellent alternative to open surgery for treatment of a herniated lumbar disc, especially if patients are selected carefully and good technique is strictly followed.



Original Text by Clifford R. Wheeless, III, MD.