Skip to main content

Technique of lumbar chemonucleolysis

  • Chapter
  • 66 Accesses

Abstract

Intrathecal injection of chymopapain causes fatal hemorrhage in rabbits and dogs [12]. To prevent the possibility of chymopapain leaking into the subarachnoid space, chemonucleolysis should not be performed immediately after myelography in order to allow any dural leak to seal [12]. McCulloch recommends a minimum delay of 24 hours [12]. We agree with other practitioners and require at least seven days between myelography and enzyme injection [1].

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Benoist M, Deburge A, Heripret J, Busson J, Rigot J. Cauchoix J (1982) Treatment of lumbar disc herniation by chymopapain chemonucleolysis: a report on 120 patients. Spine 7: 613–617

    Article  PubMed  CAS  Google Scholar 

  2. Brown JE (1969) Clinical studies on chemonucleolysis. Clin Orthop 67: 94–99

    PubMed  CAS  Google Scholar 

  3. Crock HV (1983) Practice of spinal surgery. Springer, Wien New York, pp 40

    Google Scholar 

  4. Crock HV (1984) Discography and vertebral venography before chemonucleolysis. J Neurosurg 60: 149–150

    Google Scholar 

  5. Crock HV (1986) Chymopapain. Lancet 2: 1159

    Article  CAS  Google Scholar 

  6. Dabezies EJ, Murphy CP (1985) Dural puncture using the lateral approach for chemonucleolysis. Spine 10: 93–96

    Article  PubMed  CAS  Google Scholar 

  7. Day PL (1969) Lateral approach for lumbar discogram and chemonucleolysis. Clin Orthop 67: 90–93

    PubMed  CAS  Google Scholar 

  8. Erlacher P (1952) Nucleography. J Bone Joint Surg [Br] 34: 204–210

    Google Scholar 

  9. Finneson BE (1973) Low back pain. Lippincott, Philadelphia, pp 69–76

    Google Scholar 

  10. Keck C (1960) Discography, technique and interpretation. Arch Surg 80: 580585

    Google Scholar 

  11. McCulloch JA (1977) Chemonucleolysis. J Bone Joint Surg [Br] 59: 45–52

    CAS  Google Scholar 

  12. McCulloch JA (1980) Chemonucleolysis: experience with 2,000 cases. Clin Orthop 146: 35–128

    Google Scholar 

  13. McCulloch JA, Waddell G (1978) Lateral lumbar discography. Br J Radiol 51: 498–502

    Article  PubMed  CAS  Google Scholar 

  14. Naylor A, Earland C, Robinson J (1983) The effects of diagnostic radiopaque fluids used in discography on chymopapain activity. Spine 8: 875–879

    Article  PubMed  CAS  Google Scholar 

  15. Nazarian S (1985) Anatomical basis of intervertebral disc puncture with chemonucleolysis. Anat Clin 7: 23–32

    Article  PubMed  CAS  Google Scholar 

  16. Ray CD (1984) Danger of intravenous injection during chemonucleolysis. J Neurosurg 60: 1327

    PubMed  CAS  Google Scholar 

  17. Rocolle J, Degott C, Benoist M. Lassalc B, Nedjar C, Tardivon A, Deburge A (1985) Etude expérimentale de l’action comparée de deux préparation de chymopapaïne sur le disque interverté et de l’effet de l’injection préalable d’un produit de contraste radio-opaque. Rev Chir Orthop 71 [Suppl 2]: 36

    Google Scholar 

  18. Smith L, Brown JE (1967) Treatment of lumbar intervertebral disc lesions by direct injection of chymopapain. J Bone Joint Surg [Br] 49: 502–519

    CAS  Google Scholar 

  19. Troisier O (1980) Traitement des lombosciatiques par injection intra-discale d’enzymes protéolytiques. 80 observations. Nouv Presse Med 9: 227–230

    Google Scholar 

  20. Troisier 0 (1982) Technique de la discographie extra-durale. J Radiol 63: 571–578

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Springer-Verlag/Wien

About this chapter

Cite this chapter

Laredo, JD., Busson, J., Wybier, M., Bard, M. (1988). Technique of lumbar chemonucleolysis. In: Bard, M., Laredo, JD. (eds) Interventional Radiology in Bone and Joint. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8948-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-8948-1_5

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-8950-4

  • Online ISBN: 978-3-7091-8948-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics