Experimental Intervertebral Discolysis with Collagenase

AIN caused by herniation of the intervertebral disc is relieved by surgical decompression of the affected nerve root. This is accomplished, for the most part, by removal of the protruding nucleus pulposus and fibrocartilage. Usually a limited excision will satisfactorily relieve pain. However, techniques vary among surgeons and once an operation is undertaken, each operator on the basis of his own experience usually extends the procedure to include some individual modification. This may include conservative or radical foramenotomy, major unilateral curettage of the intervertebral joint space, or bilateral total discoidectomy. The dialogue continues between neurosurgeon and orthopedic surgeon regarding the indications for spine fusion. Most surgeons, however, are aware of the favorable results that often follow conservative removal of the herniated portion of the intervertebral disc. This consideration has led to speculation concerning the feasibility of achieving this same degree of nerve root decompression non-surgically by selective enzymatic dissolution of the underlying and protruding disc. If successful, such a technique would extend the possibility of treating patients by conservative methods. This paper deals with experimental studies conducted in the dog, using the enzyme Collagenase* for intervertebral discolysis.