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

<p>Abstract</p> <p>Background</p> <p>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 in...

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Main Authors: Wardlaw Douglas, Dang Lei, Hukins David WL
Format: Article
Language:English
Published: BMC 2007-12-01
Series:BMC Musculoskeletal Disorders
Online Access:http://www.biomedcentral.com/1471-2474/8/122
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author Wardlaw Douglas
Dang Lei
Hukins David WL
author_facet Wardlaw Douglas
Dang Lei
Hukins David WL
author_sort Wardlaw Douglas
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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 chymopapain.</p>
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spelling doaj.art-b3073bca960243618c49e983ebd1d9642022-12-22T03:09:28ZengBMCBMC Musculoskeletal Disorders1471-24742007-12-018112210.1186/1471-2474-8-122Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory studyWardlaw DouglasDang LeiHukins David WL<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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 chymopapain.</p>http://www.biomedcentral.com/1471-2474/8/122
spellingShingle Wardlaw Douglas
Dang Lei
Hukins David WL
Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
BMC Musculoskeletal Disorders
title Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
title_full Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
title_fullStr Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
title_full_unstemmed Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
title_short Removal of nucleus pulposus from the intervertebral disc – the use of chymopapain enhances mechanical removal with rongeurs: a laboratory study
title_sort removal of nucleus pulposus from the intervertebral disc the use of chymopapain enhances mechanical removal with rongeurs a laboratory study
url http://www.biomedcentral.com/1471-2474/8/122
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