Inadequacies and hazards of chymopapain injections as treatment for intervertebral disc disease

Abstract

Chymopapain chemonucleolysis was performed on 100 patients with primary lumbar intervertebral disc disease. The results were compared with those of 174 patients who underwent laminotomy, foraminotomy, and discectomy. Primary lumbar intervertebral disc disease was arbitrarily divided into degenerative, complex, previous surgical, and simple disc syndromes. No difference was seen between chemonucleolysis and surgery in the first three divisions; between 55 percent and 60 per cent of patients responded successfully to treatment. In the simple disc division 89 per cent of the surgical and 60 per cent of the chemonucleolysis patients had successful results.

Minimally invasive spine technology and minimally invasive spine surgery: a historical review

“…In spite of its eventual approval by the FDA, enthusiasm for this procedure has dwindled, as several reports of arachnoiditis and other associated complications were published. 8,89,121 Descriptions of a 3-to 4-month history of low-back pain from chemical discitis were not uncommon in the postoperative course of these patients. In 1975 the first percutaneous nucleotomy technique was reported by Hijikata.…”

Percutaneous Injection of Radiopaque Gelified Ethanol for the Treatment of Lumbar and Cervical Intervertebral Disk Herniations: Experience and Clinical Outcome in 80 Patients

“…Clinical outcomes seem to be encouraging, with a high reduction of possible collateral effects. 4 The purpose of this article is to describe the results of our study in percutaneous intradiskal injection of RGE for CDH and LDH.…”

“…1 Chemonucleolysis is a minimally invasive percutaneous technique allowing intradiskal injection of various materials under fluoroscopic or CT guidance, to "digest" or dehydrate diskal portions. Materials include chymopapain, 3 now abandoned because of frequent allergic reactions, 4 and oxygen-ozone, 5 whose results have still not been completely demonstrated. Recently, a newly developed substance, radiopaque gelified ethanol (RGE), has been introduced into clinical practice.…”

Surgical injury of the cord and its roots

“…The surgeon, furthermore, must If by nothing else, by that commitment to do no harm, he is so obligated. The author has previously identified this commonplace failure to employ ordinarily effective conservative management in a study which affected more than 15,000 patients who were injected and often injured by the drug chymopapain (Sussman, 1975). The methods of this study came to be as a matter of chance curiosity con cerning the issue of adverse surgical results in a few cases where an evaluation was solicited.…”