Chemonucleolysis failures treated by PLIF.

Chemonucleolysis is a procedure in which an enzyme is injected into the intervertebral disc for the purpose of alleviating sciatic pain. This has a reported success rate of 70%-90%. Of the failures, several will benefit from a classic lumbar laminectomy for removal of a free fragment in the spinal canal caused by either improper technique or inadequate enzyme activity. However, in a significant number of cases, the failure is related to either instability or the compression of the nerve roots in the neural foramen. Observations on 17 cases demonstrate that PLIF can relieve pain and other symptoms in cases of failed chemonucleolysis.