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- Katsuhiko Ishibashi, Hiroki Iwai, and Hisashi Koga.
- Department of Orthopaedic Surgery, Iwai Orthopaedic Medical Hospital, Tokyo, Japan.
- J Spine Surg. 2019 Jun 1; 5 (Suppl 1): S115-S121.
AbstractChemonucleolysis is a minimally invasive treatment for cervical and lumbar intervertebral disc herniation (IDH). While this procedure has existed for more than 50 years, it has yet to become an established practice. The main reason for this is the low specificity of enzymes targeting nucleus pulposus (NP). Although two enzymes (chymopapain and collagenase) have been used in clinical settings, severe adverse events have discouraged widespread use. The recently introduced enzyme Proteus vulgaris chondroitin sulfate ABC endolyase may allow a new era of chemonucleolysis because of its high specificity for NP.
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