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Percutaneous Treatments

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Lumbar Disc Herniation

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Abstract

The history of chemonucleolysis begins with the observation of Lyman Smith (160) that intradiscal injection of chymopapain in rabbit dissolves the nucleus pulposus, but leaves the annulus fibrosus essentially intact. This experiment had been suggested by a previous study of Thomas (172), who found that the intravenous injection of papain in the rabbit caused drop of the ear, which resumed the erect position 48 hours later, due to a reversible action of the enzyme on the intercellular matrix of the auricular cartilage. The term “chemonucleolysis” was also coined by Smith (158), who used it to indicate the treatment of pathologic disc conditions with chymopapain injection, even if presumably he meant, with this term, the dissolution of the nucleus pulposus by a chemical substance, as the etymology of the word indicates. The first patient was treated by Smith in 1963. A few years later, he sold the patent for chymopapain, for the symbolic sum of 1 dollar, to Baxter-Travenol Laboratories, which marked the product under the trade name Discase, a combination of chymopapain, cysteine sodium sulfite and EDTA.

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Postacchini, F., Mayer, H.M. (1999). Percutaneous Treatments. In: Lumbar Disc Herniation. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6430-3_15

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