Post-chymopapain (Chemonucleolysis)-clinical and computed tomography correlation: Preliminary results

Abstract

Chymopapain was first used for treatment of lumbar disc herniation in 1964 and has been used extensively in Canada and Europe for the last decade, but was recently released for general use in the United States. The enzyme is thought to cause decrease in intradiscal pressure and in disc volume; however, little in vivo evidence exists to support this concept. High resolution computed tomography (CT) scans were performed for diagnosis and at a variable period following chemonucleolysis on 17 randomly selected patients. The results of the study were: (1) disc space narrowing occurred almost invariably; (2) retraction of the prolapsed or extruded disc occurred in many patients; (3) clinical improvement was closely related to retraction of the prolapsed or extruded disc; (4) the best clinical results were obtained in patients who were injected at a single level with a clearly demonstrable disc prolapse or herniation.