This Article  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A. S. Russell, FRCP(C)
University of Alberta Edmonton, Canada

JAMA. 1975;233(11):1164.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Wiltse et al have given us an excellent review of chymopapain chemonucleolysis in lumbar disk disease (231:474, 1975). Although they themselves have performed this procedure in 1,200 cases of lumbar disk disease, it is disappointing that all they can conclude is that "chemonucleolysis appears to be as good as laminectomy in properly selected cases." It is unfortunate to find that despite the many thousands of patients treated with this agent, Wiltse et al cannot quote a single example where the correct study has been performed, ie, comparison of the effect of therapy with the active agent, chymopapain, to that of either no treatment at all or an appropriate placebo.

In their study, Wiltse and co-workers note that 48.2% of the patients treated did not achieve their optimal result until at least four months after therapy. This looks remarkably like the natural history of lumbar disk disease. The . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?