Open AccessChemonucleolysis with chondroitin sulfate ABC endolyase as a novel minimally invasive treatment for patients with lumbar intervertebral disc herniation
Author(s) -
Katsuhiko Ishibashi,
Hiroki Iwai,
Hisashi Koga
Publication year - 2019
Publication title -
journal of spine surgery
Language(s) - English
Resource type - Journals
eISSN - 2414-469X
pISSN - 2414-4630
DOI - 10.21037/jss.2019.04.24
Subject(s) - chymopapain , medicine , intervertebral disc , lumbar disc herniation , collagenase , chondroitin sulfate , disc herniation , intervertebral disc displacement , hyaluronic acid , lumbar , surgery , lumbar vertebrae , enzyme , anatomy , biochemistry , glycosaminoglycan , chemistry
Chemonucleolysis is a minimally invasive treatment for cervical and lumbar intervertebral disc herniation (IDH). While this procedure has existed for more than 50 years, it has yet to become an established practice. The main reason for this is the low specificity of enzymes targeting nucleus pulposus (NP). Although two enzymes (chymopapain and collagenase) have been used in clinical settings, severe adverse events have discouraged widespread use. The recently introduced enzyme Proteus vulgaris chondroitin sulfate ABC endolyase may allow a new era of chemonucleolysis because of its high specificity for NP.