Journal of neurosurgery · 1983 · 27 citations · 19 references
Veterinary MedicineSurgeryAnesthesiaLocal AnesthesiaPain MedicineAnaphylaxisIntervertebral Disc DiseaseIntervertebral Disc PathologyIntervertebral DiscsOrgan Toxicity AssessmentOrgan Toxicity EvaluationProne Positioning
The authors report a 12-year follow-up review of 33 patients treated with chymopapain (Discase) injection for intervertebral disc disease. This carefully controlled series of patients was treated under local anesthesia in the prone position. Only the single offending disc that correlated with the myelographic and clinical pathology (without the use of discography) was injected with Discase. Anaphylaxis is treated instantly at the first sign of disturbance, and no patients suffered shock. The percentage of patients who were completely cured or improved continues at about 70%. Aside from sensitivity, complications attributable to proper use of the enzyme remain at zero. Follow-up review of those patients over 10 years would indicate that there is no risk of delayed organ toxicity, no risk of carcinogenesis, and no apparent risk of first-generation teratogenesis.
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Enzyme Dissolution of the Nucleus Pulposus in Humans
Lyman Smith · JAMA · 1964 · 376 citations
Current Controversies in Neurosurgery
Maurice W. Nicholson · JAMA · 1977 · 308 citations
Medicine, Neurosurgery, Surgery +7
Enzyme Dissolution of the Nucleus Pulposus
Lyman Smith, Paul J. Garvin, R.M. Gesler et al. · Nature · 1963 · 163 citations