A PROSPECTIVE RANDOMIZED TRIAL OF CHEMONUCLEOLYSIS AND CONVENTIONAL DISK SURGERY IN SINGLE LEVEL LUMBAR-DISK HERNIATION

KP MURALIKUTTAN, A HAMILTON, George Kernohan, RAB MOLLAN, IV ADAIR

Research output: Contribution to journal › Article

Abstract

The role of chemonucleolysis as an alternative to disc surgery is still disputed. The authors conducted a prospective randomized controlled trial of chemonucleolysis and conventional disc surgery involving 92 patients with L4-5 or L5-S1 disc herniation who failed to respond to conservative treatment. There were 46 patients in each group, matched for demographic, clinical characteristics, and co-interventions. Independent examiners assessed patients before treatment, at 6 weeks after, 3 months after, and 1 year after treatment. A comprehensive method of outcome assessment involving physiological outcome, functional outcome, cost outcome, and psychological outcome was employed. Nine chemonucleolysis patients and one disc surgery patient required additional surgery for failure of initial treatment (P < 0.02). The outcomes at 6 weeks and at 3 months were better in the surgical group, but at 1 year the differences were not significant. The authors conclude that chemonucleolysis as a minimally invasive technique produces inferior short-term results and offers no advantage over conventional discectomy.
LanguageEnglish
Pages381-387
JournalSPINE
Volume17
Issue number4
Publication statusPublished - Apr 1992

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Intervertebral Disc Chemolysis
Diskectomy
Treatment Failure
Research Design
Randomized Controlled Trials
Demography
Outcome Assessment (Health Care)
Psychology
Costs and Cost Analysis
Therapeutics

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MURALIKUTTAN, KP ; HAMILTON, A ; Kernohan, George ; MOLLAN, RAB ; ADAIR, IV. / A PROSPECTIVE RANDOMIZED TRIAL OF CHEMONUCLEOLYSIS AND CONVENTIONAL DISK SURGERY IN SINGLE LEVEL LUMBAR-DISK HERNIATION. 1992 ; Vol. 17, No. 4. pp. 381-387.
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abstract = "The role of chemonucleolysis as an alternative to disc surgery is still disputed. The authors conducted a prospective randomized controlled trial of chemonucleolysis and conventional disc surgery involving 92 patients with L4-5 or L5-S1 disc herniation who failed to respond to conservative treatment. There were 46 patients in each group, matched for demographic, clinical characteristics, and co-interventions. Independent examiners assessed patients before treatment, at 6 weeks after, 3 months after, and 1 year after treatment. A comprehensive method of outcome assessment involving physiological outcome, functional outcome, cost outcome, and psychological outcome was employed. Nine chemonucleolysis patients and one disc surgery patient required additional surgery for failure of initial treatment (P < 0.02). The outcomes at 6 weeks and at 3 months were better in the surgical group, but at 1 year the differences were not significant. The authors conclude that chemonucleolysis as a minimally invasive technique produces inferior short-term results and offers no advantage over conventional discectomy.",
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MURALIKUTTAN, KP, HAMILTON, A, Kernohan, G, MOLLAN, RAB & ADAIR, IV 1992, 'A PROSPECTIVE RANDOMIZED TRIAL OF CHEMONUCLEOLYSIS AND CONVENTIONAL DISK SURGERY IN SINGLE LEVEL LUMBAR-DISK HERNIATION', vol. 17, no. 4, pp. 381-387.

A PROSPECTIVE RANDOMIZED TRIAL OF CHEMONUCLEOLYSIS AND CONVENTIONAL DISK SURGERY IN SINGLE LEVEL LUMBAR-DISK HERNIATION. / MURALIKUTTAN, KP; HAMILTON, A; Kernohan, George; MOLLAN, RAB; ADAIR, IV.

Vol. 17, No. 4, 04.1992, p. 381-387.

Research output: Contribution to journal › Article

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AB - The role of chemonucleolysis as an alternative to disc surgery is still disputed. The authors conducted a prospective randomized controlled trial of chemonucleolysis and conventional disc surgery involving 92 patients with L4-5 or L5-S1 disc herniation who failed to respond to conservative treatment. There were 46 patients in each group, matched for demographic, clinical characteristics, and co-interventions. Independent examiners assessed patients before treatment, at 6 weeks after, 3 months after, and 1 year after treatment. A comprehensive method of outcome assessment involving physiological outcome, functional outcome, cost outcome, and psychological outcome was employed. Nine chemonucleolysis patients and one disc surgery patient required additional surgery for failure of initial treatment (P < 0.02). The outcomes at 6 weeks and at 3 months were better in the surgical group, but at 1 year the differences were not significant. The authors conclude that chemonucleolysis as a minimally invasive technique produces inferior short-term results and offers no advantage over conventional discectomy.

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MURALIKUTTAN KP, HAMILTON A, Kernohan G, MOLLAN RAB, ADAIR IV. A PROSPECTIVE RANDOMIZED TRIAL OF CHEMONUCLEOLYSIS AND CONVENTIONAL DISK SURGERY IN SINGLE LEVEL LUMBAR-DISK HERNIATION. 1992 Apr;17(4):381-387.