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Chemonucleolysis in the Treatment of Lumbar Disc Disease.

Authors
Apfelbach-HW
Source
NIOSH 1978 Jun:95-99
Link
NIOSHTIC No.
00184892
Abstract
The use of chemonucleolysis in the treatment of discogenic pain associated with lumbar disc disease was described. The anatomy and physiology of the intervertebral disc were reviewed in reference to changes occurring with age that contribute to degenerative disc disease. Chemonucleolysis involved the injection of therapeutic doses of chymopapain into the intervertebral disc space to induce depolymerization of mucoprotein. The indications for chemonucleolysis were comparable to those for laminectomy and included those patients in which laminectomy failed and those patients indicated for repeat laminectomies. Contraindications to chemonucleolysis included neurologic deficits, spinal stenosis, arachnoiditis, pregnancy, and previous chemonucleolysis. Preoperative evaluation included electromyography to confirm the presence of a herniated disc, myelography to discount spinal stenosis and spinal cord tumor, epidural venography, and prognostic psychometric testing. The technique, postoperative treatment, and complications of the chemonucleolytic procedure were described.
Keywords
Back-injuries; Medical-treatment; Humans; Skeletal-system-disorders; Musculoskeletal-system-disorders; Nervous-system-disorders; Spinal-cord;
Publication Date
19780601
Document Type
Conference/Symposia Proceedings;
Fiscal Year
1978
NTIS Accession No.
NTIS Price
Identifying No.
(NIOSH) 78-169
NIOSH Division
DTS;
Priority Area
Low Back Disorders; Disease and Injury; Musculoskeletal-system-disorders;
Source Name
Occupational Safety and Health Symposia, 1977, Division of Technical Services, NIOSH, U.S. Department of Health, Education, and Welfare, Cincinnati, Ohio, DHEW (NIOSH) Publication No. 78-169
State
OH;
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