Treatment of herniated lumbar disk syndrome with chymopapain
M. J. Javid
One hundred twenty-four patients with herniated lumbar disks received
intradiskal injections of chymopapain before the Food and Drug
Administration's withdrawal of the drug. One year after injection, 90
patients (72.6%) experienced major improvement, 21 (16.9%) had slight
improvement, and 13 (10.5%) had no improvement. Of those patients who had
no previous back surgery and who were not compensation cases, 77 patients
(81%) had marked improvement, 13 (13.7%) had slight improvement, and five
(5.3%) had no improvement. Three- to six-year follow-ups were obtained by
questionnaire. Of the 114 patients responding, overall 83 patients (72.8%)
had marked improvement, and 75 (83.3%) of those with no previous surgery
and who were not workmen's compensation cases had major improvement. Since
all patients met objective criteria for diskectomy, favorable results from
chemonucleolysis spared most the trauma of surgery and its attendant
convalescence. These results indicate that chemonucleolysis can and should
be considered an advantageous alternative to surgery in appropriately
selected patients.
