LUMBAR DISCAL HERNIATION IN THE ELDERLY -LONG-TERM OUTCOME AFTER CHYMOPAPAIN CHEMONUCLEOLYSIS

The purpose of this study was to evaluate the outcome after chymopapai n chemonucleolysis in elderly patients with low back pain and sciatica due to lumbar disc herniation without concomitant stenosis, unrespons ive to conservative therapy. In the 42 study patients, aged 60 years o r older, clinical manifestations were similar to those usually seen in younger patients. Evidence of nerve root tension, including a positiv e straight-leg raising test seen in 67 % of our patients, proved valua ble for outruling sciatica due to bony impingement. Outcome was favora ble in 78 % of cases after a mean follow-up of 2.5 years. This finding s is consistent with previous studies performed without age restrictio ns. Chemonucleolysis had no adverse effects. Despite the biochemical c hanges which occur in the aging disc, chemonucleolysis is an effective tool for the treatment of sciatica due to disc herniation in elderly patients.