Treatment of disk sciatica by chemonucleolysis. 120 cases

Benoist, M.; Rigot, J.; Deburge, A.; Heripret, G.; Busson, J.; Cauchoix, J.

Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur 68(4): 261-267


ISSN/ISBN: 0035-1040
PMID: 6217515
Document Number: 196238
One hundred and twenty patients suffering some sciatica due to disc herniation have been treated by chemonucleolysis. All the patients had received conservative treatment for at least four months. The minimum followup after nucleolysis was six months. In 114 patients, radiculography was positive and in 6, radiculography was negative but phlebography was positive. Patients with symptoms of spinal stenosis, or with signs of sequestrated disc or who had been previously operated on by laminectomy were excluded from the study. By a lateral extradural approach, 4000 units of chymopapain were injected into the disc under general anaesthesia after discography. All patients except 3 had only disc injected. Results were good in 92 patients. 21 of the 28 failures were operated on. In 18 cases, a mechanical cause was found at operation with 16 good results. Complications were rare and benign. No neurological complication was noted. It is concluded that chemonucleolysis should be the last step in the conservative management of sciatica.

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