Treatment of lumbar disk hernias using chemonucleolysis

: The authors present 46 cases studies of herniated lumbar discs treated by chemonucleolysis in the previous 2 to 9 months. One patient suffered from recurrent acute lumbago; the other 45 patients suffered from lumbar root pain. The diagnosis of herniated disc was confirmed by radiography of the lumbar roots. Chemonucleolysis was performed under neuroleptanalgesia in the majority of cases, after failure of medical treatment and as an alternative to surgery. The patient treated for recurrent lumbago obtained a good result. After one month, 20 patients no longer suffered from sciatica and two had only a mild and intermittent sciatic pain. The results are lasting. Overall, chemonucleolysis is successful in 69% of cases. The success rate decreases with the age of the patient and the age of the symptoms. The results appear to be unchanged by the number of discs treated, their level or their discographic features. The results appear to be unchanged by the number of discs treated, their level or their discographic features. The results seem to be better when the disc being treated has not collapsed and when the hernia is not too large. Seven failed cases went to operation when, in each case, a non ruptured herniated disc was found. In 4 cases there was minimal tissue and in 2 cases the hernia was soft. The tolerance was excellent. Chemonucleolysis is effective in the treatment of herniated lumbar discs, but should be reserved for selected patients. Used with care, the treatment is safe. In cases where the treatment fails, the surgical procedure is not interefered with.