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Injection of Collagenase in the Treatment of Herniated Lumbar DiskInitial Clinical Report
Bernard J. Sussman, MD;
John W. Bromley, MD;
Jaime C. Gomez, MD
JAMA. 1981;245(7):730-732.
Abstract
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.
(JAMA 1981;245:730-732)
Author Affiliations
From the Division of Neurological Surgery, Howard University College of Medicine, Washington, DC (Dr Sussman); the Department of Orthopedic Surgery, Bellevue Medical Center, New York University (Dr Bromley); and the Department of Surgical Neurology, the Neurological Institute of Colombia, Bogota (Dr Gomez).
Footnotes
Reprint requests to Division of Neurological Surgery, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC 20060 (Dr Sussman).
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