Sagher O, Szabo T A, Chenelle A G, Jane J A
Section of Neurosurgery, University of Michigan Medical Center, USA.
Spine (Phila Pa 1976). 1995 Sep 1;20(17):1923-7. doi: 10.1097/00007632-199509000-00015.
This is a report of a series of 104 patients who underwent lumbar discectomy and chemonucleolysis at the University of Virginia between 1985 and 1989.
The primary objective was to determine the safety of this procedure. A secondary objective was to begin studying its efficacy.
This is the first report on the use of chymopapain during open surgery.
Patients with low back pain and radicular symptoms not cured with conservative therapy were selected for participation in the study. Intraoperatively, disc spaces were injected with 2 ml of chymopapain. Patients were followed-up for an average of 5 years. Patients were surveyed regarding pain relief, and failures of the procedure were analyzed.
Seventy percent of patients reported good or excellent pain relief. Operative failures, characterized by reoperation at the same level, totaled 9.6%. Recurrent disc herniation at the time of reoperation occurred in 4.8%.
The procedure is safe and the relief of pain was similar to that in other published series. The suggestion is that the rate of recurrent disc herniation is reduced.
这是一份关于1985年至1989年间在弗吉尼亚大学接受腰椎间盘切除术和化学髓核溶解术的104例患者的系列报告。
主要目的是确定该手术的安全性。次要目的是开始研究其疗效。
这是关于在开放手术中使用木瓜凝乳蛋白酶的首份报告。
选择经保守治疗未治愈的腰痛和神经根症状患者参与研究。术中，向椎间盘间隙注射2毫升木瓜凝乳蛋白酶。对患者平均随访5年。就疼痛缓解情况对患者进行调查，并分析手术失败情况。
70%的患者报告疼痛缓解良好或极佳。以同一节段再次手术为特征的手术失败率总计为9.6%。再次手术时复发性椎间盘突出的发生率为4.8%。
该手术安全，疼痛缓解情况与其他已发表系列研究相似。提示复发性椎间盘突出率降低。
