Injection of collagenase in the treatment of herniated lumbar disk. Initial clinical report
B. J. Sussman, J. W. Bromley and J. C. Gomez
Twenty-nine patients with persistent, low back and sciatic pain received
intradiscal collagenase at a single abnormal disk space after two months of
conservative therapy and two weeks of additional bed rest. Complete pain
relief was achieved in six patients (21%), notable relief in 12 (42%),
moderate in six (21%), and slight in one. Four patients (14%) who obtained
no improvement by enzyme injection recovered after extruded disk fragments
were removed from the spinal canal during a later operation. Pain relief
after collagenase injection took place gradually over a two- to three-week
period and was associated with some early backache. Improvement then
continued at a slower rate for two to three months. There were no adverse
effects of enzyme therapy. Injected disk spaces usually showed radiological
narrowing.
