Research Repository

See what's under the surface

Removal of nucleus pulposus from the intervertebral disc - the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study.

Dang, Lei; Wardlaw, Douglas; Hukins, David W.L.

Authors

Lei Dang

Douglas Wardlaw

David W.L. Hukins

Abstract

Background A laboratory study was conducted, on cadaveric sheep spines to develop an effective procedure for removing as much nucleus as possible from an intervertebral disc with minimal disruption to the annulus. The results of many studies involving removal of nucleus, including chemonucleolysis, using chymopapain, have been published but we are not aware of any previous quantitative studies on procedures for removing as much nucleus as possible from the disc. Methods All procedures were performed via a 3 mm trocar. Four procedures were compared: (I) unilateral approach using rongeurs alone, (II) bilateral approach using rongeurs alone, (III) unilateral approach using rongeurs followed by chymopapain and (IV) bilateral approach using rongeurs followed by chymopapain. Results The percentages of nucleus removed were: (I) 34%, (II) 41%, (III) 52% and (IV) 75%; there were significant differences between the four sets of results according to ANOVA. Conclusion Significantly more nucleus is removed using a bilateral than a unilateral approach; significantly more nucleus is removed if chymopapain is used in addition to rongeurs. A brush is useful in removing strands of nucleus loosened by chymopapainB

Journal Article Type Article
Publication Date Aug 31, 2007
Journal BMC musculoskeletal disorders
Electronic ISSN 1471-2474
Publisher Springer (part of Springer Nature)
Peer Reviewed Peer Reviewed
Volume 8
Article Number 122
Institution Citation DANG, L., WARDLAW, D. and HUKINS, D.W.L. 2007. Removal of nucleus pulposus from the intervertebral disc - the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study. BMC musculoskeletal disorders [online], 8, article 122. Available from: https://doi.org/10.1186/1471-2474-8-122
DOI https://doi.org/10.1186/1471-2474-8-122
Keywords Laboratory study; Cadaveric sheep spines; Nucleus; Inververtebral disc

Files




Downloadable Citations