Chemonucleolysis for Lumbar Disc Herniation

Five patients treated with chymopapain injection was evaluated by clinical, radiological and MRI method. The mean age was 34.6 years. Four of them had satisfactory results but recurrent pain resulted in one case. Clinical outcome by Japanese Orthopaedic Association (J. O. A.) score after 12 months was 73.9%. Disc space height was gradually decreased except for one case. Disc herniation was observed to gradually diminish in size for 4 cases, whereas disc bulging resulted in one acute disc height decrease. As the result, it was confirmed that degree of disc degeneration might be related to disc space height after chemonucleolysis and to be important to judge which disc herniation segment was dissolved by chymopapain. It seemed that discography and MRI were most excellent preinjection examination.