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European Spine Journal logoLink to European Spine Journal
. 2001 Apr 6;10(3):192–202. doi: 10.1007/s005860000234

Chemonucleolysis: the state of the art

James W Simmons 1, Eugene J Nordby 2, Alexander G Hadjipavlou 3
PMCID: PMC3611493  PMID: 11469729

Abstract.

This review presents the history of chemonucleolysis, the techniques, indications, contraindications, and complications. Presenting an historical overview and comparison of success rates with surgical discectomy may provide a fresh understanding of the controversy surrounding chemonucleolysis and establish its efficacy in relation to more invasive treatments. A review of the literature from 1973 through 1998 for chemonucleolysis, open discectomy, and microdiscectomy provided published success rates for these procedures, and a mean rate with standard deviation was determined. In the experience and opinion of the authors, chemonucleolysis remains a viable alternative for patients who have exhausted all conservative means of treatment. Proper patient selection leads to success rates comparable to open discectomy and microdiscectomy.

Keywords: Chemonucleolysis Open discectomy Microdiscectomy Chymopapain

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