Inadequacies and hazards of chymopapain injections as treatment for intervertebral disc disease

1975 ◽  
Vol 42 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Bernard J. Sussman
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Neural Tissue ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Content Type ◽  
Fine Print

✓ The author reviews laboratory and clinical reports that lead him to believe that chymopapain does not specifically dissolve the nucleus pulposus and is toxic for vascular and neural tissue.

Treatment of protruded lumbar intervertebral discs with chymopapain (Discase)

1973 ◽  
Vol 39 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Dwight Parkinson ◽  
Christopher Shields
Keyword(s):  
Intervertebral Disc ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Intervertebral Discs ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Chemical Action ◽  
Content Type ◽  
Fine Print

✓ Thirty-three intervertebral disc patients who otherwise would have been subjected to surgery were treated by injection with chymopapain. The pharmacology, toxicology, physiology, immunology, and chemical action of this enzyme, which specifically reacts with chondromucoproteins, are discussed. Results indicate that this method, although still experimental and unapproved by the U. S. Food and Drug Administration, may become a useful addition to the surgeon's armamentarium in the treatment of intervertebral disc disease.

Chymopapain treatment of intervertebral disc disease

1975 ◽  
Vol 42 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Clark Watts ◽  
Robert Knighton ◽  
George Roulhac
Keyword(s):  
Intervertebral Disc ◽  
Proteolytic Enzyme ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Space ◽  
Content Type ◽  
Disc Material ◽  
Capillary Endothelial Cells ◽  
Fine Print ◽  
Rapid Conversion

✓ In the first of a two-part study, the authors review the known biochemical, pharmacological, toxicological, and experimental data concerning chymopapain and the intervertebral disc. They describe the action of this proteolytic enzyme, which apparently disrupts the protein mucopolysaccharide component of disc material, most marked in the nucleus pulposus. A rapid conversion to collagen causes a loss of disc space height; toxicity appears to result from alteration of bonding between capillary endothelial cells that in turn produces hemorrhage. Part 2 reviews significant reported results and complications of clinical chemonucleolysis.

Late results of treatment of intervertebral disc disease with chymopapain

1983 ◽  
Vol 59 (6) ◽  
pp. 990-993 ◽  
Author(s):  
Dwight Parkinson
Keyword(s):  
Intervertebral Disc ◽  
First Generation ◽  
Clinical Pathology ◽  
Late Results ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Content Type ◽  
Results Of Treatment ◽  
Fine Print

✓ The authors report a 12-year follow-up review of 33 patients treated with chymopapain (Discase) injection for intervertebral disc disease. This carefully controlled series of patients was treated under local anesthesia in the prone position. Only the single offending disc that correlated with the myelographic and clinical pathology (without the use of discography) was injected with Discase. Anaphylaxis is treated instantly at the first sign of disturbance, and no patients suffered shock. The percentage of patients who were completely cured or improved continues at about 70%. Aside from sensitivity, complications attributable to proper use of the enzyme remain at zero. Follow-up review of those patients over 10 years would indicate that there is no risk of delayed organ toxicity, no risk of carcinogenesis, and no apparent risk of first-generation teratogenesis.

Comparison of intervertebral disc disease treatment by chymopapain injection and open surgery

1975 ◽  
Vol 42 (4) ◽  
pp. 397-400 ◽  
Author(s):  
Clark Watts ◽  
Gary Hutchison ◽  
Jack Stern ◽  
Kemp Clark
Keyword(s):  
Intervertebral Disc ◽  
Open Surgery ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disease Treatment ◽  
Lumbar Intervertebral Disc ◽  
Content Type ◽  
Fine Print

✓ Chymopapain chemonucleolysis was performed on 100 patients with primary lumbar intervertebral disc disease. The results were compared with those of 174 patients who underwent laminotomy, foraminotomy, and discectomy. Primary lumbar intervertebral disc disease was arbitrarily divided into degenerative, complex, previous surgical, and simple disc syndromes. No difference was seen between chemonucleolysis and surgery in the first three divisions; between 55% and 60% of patients responded successfully to treatment. In the simple disc division 89% of the surgical and 60% of the chemonucleolysis patients had successful results.

scholarly journals Fibrocartilaginous Embolism Associated with the Extrusion of the Intervertebral Disc in a Dog

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Rafael Oliveira Chaves ◽  
Bruna Copat ◽  
Diego Vilibaldo Beckmann ◽  
João Pedro Scusssel Feranti ◽  
Marília Teresa De Oliveira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Cord Compression ◽  
Spinal Reflexes ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Hind Limbs ◽  
Fibrocartilaginous Embolism ◽  
Disc Extrusion

Background: Intervertebral disc disease is a usual neurological disorder in dogs, which the spinal cord is compressed by intervertebral disc extrusion or protrusion. Fibrocartilaginous embolic myelopathy isan acute infarction disease of spinal cord caused by fibrocartilaginous emboli histologically identical to the nucleus pulposus of intervertebral discs. The aim of this report is present two cases of fibrocartilaginous embolic myelopathy in dogs with intervertebral disc disease.Cases: Two dogs - dachshund breed - were referred to the Veterinary Medical Teaching Hospital of the UFSM. In the first case, the dog was three years old and the owner described complete inability to move the pelvic limbs. The neurological examination revealed paraplegia, postural reactions deficits, normal spinal reflexes and muscle tonus in the hind limbs, pain on palpation in T12-T11 region and loss of deep pain in hind limbs. In the other case, the dog was seven years old and the owner described partial inability to move four limbs. The neurological examination revealed non-ambulatory tetraparesis, postural reactions deficit, normal spinal reflexes in four limbs and pain on palpation in cervical spine. In both cases, the presumptive diagnosis was intervertebral disc disease and surgical treatment was indicated. The dog with thoracolumbar injury died during the anesthesia and the dog with cervical injury was euthanized, after decision of owner. During the necropsy was observed intervertebral disc extrusion between L1-L2 vertebrae in a dog and between C3-C4 vertebrae in the other case with cartilaginous fragments in the spinal canal. Histopathology revealed marked diffuse necrosis with multifocal hemorrhage and cartilaginous emboli.Discussion: Fibrocartilaginous embolic myelopathy is commonly reported in large and giant breed dogs, though also occur in small and medium-sized breeds of dogs. One hypothesis is the pulpous nucleus remains soft for a longer period in large breed dogs, empowering to infiltration in the spinal cord vessels. The intervertebral disc extrusion occurs predominantly in dogs with age between three and six years old, in the cervical, thoracolumbar (T11-L3) and lumbar regions. Chondroid or fibroid degeneration of the intervertebral disc is the most common cause of spinal cord compression in small animals. In chondrodistrophic breed dogs is frequently chondroid degeneration, which the nucleus pulposus moves into the spinal canal through rupture of the annulus fibrosus (extrusion or Hansen type I), causing acute spinal cord compression. The prevalence of fibrocartilaginous embolism in adult and old dogs increase the possibility of predisposing factors, facilitating the injection intravascular of nucleus pulposus material. One of the most accepted theories about the mechanism of fibrocartilaginous emboli into the vessels is due to increase of inside discal pressure and liberation of fibrocartilaginous emboli from nucleus pulposus into the vertebral artery for retrograde flow, reaching the spinal cord by blood flow. The simultaneous occurrence of intervertebral disc disease and the infarction of spinal cord in the proximate region accentuate the hypothesis that the etiology of fibrocartilaginous embolic myelopathy is mechanical into the vessels of the spinal cord.Keywords: neurology, spinal cord, intervertebral disc disease, dogs.

scholarly journals Diagnostic Imaging in Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Ronaldo C. da Costa ◽  
Steven De Decker ◽  
Melissa J. Lewis ◽  
Holger Volk ◽  
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Disc Extrusion

Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.

scholarly journals The Changing RNAome of the Developing Nucleus Pulposus of the Intervertebral Disc: Implications for Intervertebral Disc Disease

2015 ◽  
Vol 5 (1_suppl) ◽  
pp. s-0035-1554146-s-0035-1554146
Author(s):  
Kathryn S. E. Cheah ◽  
Tiffany Au ◽  
Ben Niu ◽  
Danny Chan ◽  
Michael Q. Zhang
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Intervertebral Disc Disease ◽  
Disc Disease

scholarly journals circSPG21 protects against intervertebral disc disease by targeting miR-1197/ATP1B3

2021 ◽  
Author(s):  
Yizhen Huang ◽  
Zhenlei Zhang ◽  
Jianle Wang ◽  
Shuying Shen ◽  
Teng Yao ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Circular Rnas ◽  
Intervertebral Disc Disease ◽  
Nucleus Pulposus Cells ◽  
Disc Disease ◽  
Downstream Target ◽  
Effective Therapeutic Strategy ◽  
Human Npcs ◽  
Competitive Endogenous Rna

AbstractThe abnormal expression of circular RNAs (circRNAs) is associated with numerous human diseases. This study investigated the mechanism by which circRNA acts as competitive endogenous RNA in the regulation of degenerative intervertebral disc disease (IVDD). Decreased expression of circSPG21 was detected in degenerated nucleus pulposus cells (NPCs), the function of circSPG21 in NPCs was explored and verified, and the downstream target of circSPG21 was investigated. The interaction between circSPG21 and miR-1197 and its target gene (ATP1B3) was studied by online database prediction and molecular biological verification. Finally, the circSPG21/miR-1197/ATP1B3 axis was verified in the mouse tail-looping model. The expression of circSPG21 in the nucleus pulposus in IVDD was directly related to an imbalance of anabolic and catabolic factors, which affected cell senescence. circSPG21 was found to play a role in human NPCs by acting as a sponge of miR-1197 and thereby affecting ATP1B3. The regulation of circSPG21 provides a potentially effective therapeutic strategy for IVDD.

scholarly journals Effects of interleukin-17A in nucleus pulposus cells and its small-molecule inhibitors for intervertebral disc disease

2018 ◽  
Vol 22 (11) ◽  
pp. 5539-5551 ◽  
Author(s):  
Kaori Suyama ◽  
Daisuke Sakai ◽  
Noriaki Hirayama ◽  
Yoshihiko Nakamura ◽  
Erika Matsushita ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Small Molecule ◽  
Small Molecule Inhibitors ◽  
Intervertebral Disc Disease ◽  
Nucleus Pulposus Cells ◽  
Disc Disease ◽  
Interleukin 17A

Dislocated lumbar vertebral epiphysis in adolescent children

1973 ◽  
Vol 38 (2) ◽  
pp. 232-234 ◽  
Author(s):  
John J. Lowrey
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Spinal Canal ◽  
Lumbar Intervertebral Disc ◽  
Content Type ◽  
Fine Print

✓ Three teenagers operated on for suspected rupture of a lumbar intervertebral disc are presented. The finding at surgery in each case was a bony, cartilaginous, and nucleus pulposus ridge crossing the anterior spinal canal. Since the bony epiphyseal ring or apophysis is said to be deficient posteriorly, these patients presumably had a dislocation of an anomalous epiphyseal ring.

Sign in / Sign up

Export Citation Format

Share Document