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Sciatica — management by chemonucleolysis versus surgical discectomy

  • Spinal disorders
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Summary

Two therapeutic approaches designed specifically to relieve the symptoms of sciatica and resolve the signs of lumbar radiculopathy brought about by herniation of the nucleus pulposus have evolved. The surgical removal of the lumbar disc is an operation which has undergone miniaturization in recent years. Treatment of disc hernia by chemical hydrolysis of the nucleus pulposus (chemonucleolysis) has, over the past 20 years, become an alternative to open surgical treatment. These two forms of therapy are compared as to their efficacy and safety. Neurosurgeons now have the data to decide on the suitability of employing one or the other (or both) of these forms of treatment in the care of patients with intractable sciatica.

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References

  1. Agre, K.: Serious neurological adverse events associated with administration of Chymodiactin (R). In: Nordby, E. J. (ed.): Chemonucleolysis, Slack Inc., Thorofare, N.J. 1985

    Google Scholar 

  2. Brown, H. A., M. E. Pont: Disease of lumbar discs — 10 years of surgical treatment. J. Neurosurg. 20 (1963) 410–417

    PubMed  Google Scholar 

  3. Fraser, R. D.: Chymopapain for the treatment of intervertebral disc herniation — a preliminary report of a double-blind study. Spine 7 (1982) 608–612

    PubMed  Google Scholar 

  4. Gurdjian, E. S., A. S. Ostrowski, et al.: Results of operative treatment of protruded and ruptured lumbar discs. J. Neurosurg. 18 (1961) 783–791

    PubMed  Google Scholar 

  5. Horwitz, N. H., J. A. Curtin: Prophylactic antibiotics and wound infections following laminectomy for lumbar disc herniation. J. Neurosurg. 43 (1975) 727–731

    PubMed  Google Scholar 

  6. Javid, M. J., et al.: Safety and efficiency of Chymopapain (Chymodiactin) in herniated nucleus pulposis with sciatica — results of a randomized, double-blind study. J.A.M.A. 249 (1983) 2489–2494

    PubMed  Google Scholar 

  7. Machiavelli: “A New Order of Things” from THE PRINCE, 1513.

  8. Mayfield, F. H.: Complications of Laminectomy. Clin. Neurosurg. 23 (1976) 435–439

    PubMed  Google Scholar 

  9. Mixter, W. J., J. S. Barr: Rupture of the intervertebral disc with involvement of the spinal canal. N. Engl. J. Med. 211 (1934) 210–215

    Google Scholar 

  10. McLaren, A. C., S. I. Bailey: Cauda equina syndrome: A complication following lumbar discectomy. Scientific Program. Am. Acad. Orthop. Surg. Paper 179, p. 117. 1984

    Google Scholar 

  11. Oppel, F., J. Schramm, M. Schirmer, M. Zeitner: Results and complicated course after surgery for lumbar disc herniation. Adv. Neurosurg. 4 (1977) 36–51

    Google Scholar 

  12. Roberts, M. P.: Mortality rate of lumbar laminectomy for herniated intervertebral disc. Scientific manuscripts. Am. Assoc. Neurolog. Surg. Paper 36, pp. 68–69. 1984

    Google Scholar 

  13. Smith, L.: Enzyme dissolution of the nucleus pulposis in humans. J.A.M.A. 187 (1964) 137–140

    PubMed  Google Scholar 

  14. Spangfort, E. V.: The lumbar disc herniation. Acta Orthop. Scand. [Suppl.] 142 (1972) 1–95

    Google Scholar 

  15. Tavakol, K., et al.: Specificity of Chymopapain and collagenase actions on human intervertebral disc tissue: an in vitro study. Trans. Orthop. Res. Soc. 10 (1985) 321

    Google Scholar 

  16. Watts, C.: Complications of chemonucleolysis for lumbar disc disease. Neurosurgery 1 (1977) 2

    PubMed  Google Scholar 

  17. Weir, B. K. A.: Prospective study of 100 lumbosacral discectomies. J. Neurosurg. 50 (1979) 283–289

    PubMed  Google Scholar 

  18. Williams, R.: A conservative surgical approach to the virgin herniated lumbar disc. Spine 3 (1978) 175

    PubMed  Google Scholar 

  19. Wilson, D. H., R. Harbaugh: Microsurgical and standard removal of the protruded lumbar disc: a comparative study. Neurosurgery 8 (1981) 433–437

    Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Neurosciences, University of Calgary — Foothills Hospital, T2N 2T9, Calgary, Alberta, Canada

    Francis E. LeBlanc

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  1. Francis E. LeBlanc
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LeBlanc, F.E. Sciatica — management by chemonucleolysis versus surgical discectomy. Neurosurg. Rev. 9, 103–107 (1986). https://doi.org/10.1007/BF01743059

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  • DOI: https://doi.org/10.1007/BF01743059

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