Clinical and electromyographic evaluation after chemonucleolysis for lumbar disk disease.

Results in 200 patients with lumbar disk disease who had chemonucleolysis were evaluated by two means. First, the surgeon evaluated the patients clinically from 6 to 30 months after chemonucleolysis by rating each case as excellent, good, fair, or unimproved. Results were judged excellent or good in 91% of the 153 "clean" cases (without previous operation) and in 53% of the 36 with previous operation; 11 patients were lost to follow-up. No patients were clinically worse than before treatment. Scond, a physiatrist did a repeat electromyogram three months or longer after chemonucleolysis. He judged a patient improved if there was a decrease or disappearance of the positive waves and/or fibrillation potentials noted on initial electromyogram. Based on these objective findings, 90.5% of "clean" cases and 85.4% overall showed improvement. Surgeons' clinical evaluations and the independent physiatrical evaluations based on objective electromyographic findings thus correlated closely.