Chemonucleolysis with chymopapain is indicated in the majority of pati
ents who are candidates for surgery for intractable sciatica due to he
rniated nucleus pulposus. It is safer, as effective, and cheaper than
standard surgical discectomy, providing that patients are well selecte
d and the procedure is properly performed. Because the indication for
chemonucleolysis is not limited to contained discs, it has proved to b
e more effective than percutaneous discectomy. At present, of all perc
utaneous methods, lumbar chymopapain nucleolysis is the only procedure
that has withstood the test of time. It is an attractive alternative
to surgical discectomy and should be presented for consideration to pa
tients who meet the criteria for the procedure.