Chemonucleolysis: experience with 2000 cases.

Chemonucleolysis is a safe, relatively minor procedure which can be done with the patient under local anesthesia. If the procedure is confined to patients with sciatica resulting from a herniated intervertebral disk, and patients with non-organic spinal pain, spinal stenosis and poor response to previous surgery are excluded, good results can be anticipated. It is important that the technique include proper placement of the needle and injection of adequate amounts of chymopapain into a disk space which is free of other materials. Chemonucleolysis is a good procedure to bridge the wide gulf between standard conservative treatment and surgery.