[Chemonucleolysis in the treatment of disk lumbo-radiculalgia. Cooperative study of 333 cases].

A retrospective study was carried out of 333 patients who had been treated by chemonucleolysis with chymopapain. The efficacy and safety of this treatment were evaluated and factors exerting a statistically significant effect on the quality of the results were selected from clinical and radiological data and the conditions of chemonucleolysis. Results were satisfactory in 70.5% of cases. Complications were seen in 2.8% of cases, all of which developed favorably; three of four started work again within four months, without change of job in 84% of cases. 11% of patients underwent surgery after failure of nucleolysis. There was no statistically significant evidence that results were influenced by age, sex, duration of painful episode justifying nucleolysis, the duration of the first lumbar pains or radiculalgia, the radiographic condition of the treated disc before nucleolysis or the radiographic condition of the lumbar section of the spine. There was also no significant effect of the extent of discoradicular interaction (as seen by radiography), the number of levels treated or the site of nucleolysis. In contrast, the frequency of satisfactory results was significantly higher when nucleolysis was carried out for mono-radicular sciatica, when Lasègue's sign was noted and when marked discal degeneration was seen by discography.