Dabezies E J, Beck C, Shoji H
Clin Orthop Relat Res. 1986 May(206):10-4.
Three hundred fifty-nine patients with herniated nucleus pulposus syndrome were treated by chemonucleolysis with chymopapain. Good to excellent results were achieved in 71% with a minimum of six months follow-up observation. In a group followed for an average of ten years, the result was favorable in 86.6%; 58% of all patients injected had a good to excellent long-term result. Disc space narrowing averaged 2 mm, with no adverse effect on the result. Firm conclusions about the cause of failure of chemonucleolysis could not be drawn. Injection at two levels was recommended when a single offending level could not be identified. There were no cases of anaphylaxis with a premedication regimen of dexamethasone, diphenhydramine, and cimetidine. The procedure was safe and the results were reproducible.
359例髓核突出综合征患者接受了木瓜凝乳蛋白酶化学溶核治疗。经至少6个月的随访观察，71%的患者取得了良好至极佳的效果。在平均随访10年的一组患者中，86.6%的患者效果良好；所有接受注射的患者中有58%取得了良好至极佳的长期效果。椎间盘间隙平均变窄2毫米，对治疗效果无不良影响。关于化学溶核失败原因无法得出确凿结论。当无法确定单一病变节段时，建议在两个节段进行注射。采用地塞米松、苯海拉明和西咪替丁的预处理方案时，未发生过敏反应病例。该手术安全，结果具有可重复性。
