Chemonucleolysis: the state of the art

This review presents the history of chemonucleolysis, the techniques, indic ations, contraindications, and complications. Presenting an historical over view and comparison of success rates with surgical discectomy may provide a fresh understanding of the controversy surrounding chemonucleolysis and es tablish its efficacy in relation to more invasive treatments. A review of t he literature from 1973 through 1998 for chemonucleolysis, open discectomy, and microdiscectomy provided published success rates for these procedures, and a mean rate with standard deviation was determined. In the experience and opinion of the authors, chemonucleolysis remains a viable alternative f or patients who have exhausted all conservative means of treatment. Proper patient selection leads to success rates comparable to open discectomy and microdiscectomy.