Chemonucleolysis versus open discectomy: A ten-year follow-up study

Retrospectively 156 patients with an average follow-up period of 10.3 years were classified in two groups. Group I, 85 patients, chose chymopapain as their primary treatment. Group II, 71 patients, elected to have a laminectomy with discectomy. Overall, 98% of patients responded to follow-up investigations. Based on several well-accepted pain outcome measures there were no significant differences between the two groups at ten years. Recurrence rates, however, were greater following open discectomy at one- and ten-year follow-up examination. The question of when to return a patient to work yielded interesting results. Those patients returning to work before feeling completely recovered from symptoms had a poorer outcome at final follow-up examination.