Method of treatment of cervical osteochondrosis by intradiscal administration of small doses of papain: morphological substantiation and clinical application

Abstract

Experiments in 91 rabbits were performed to study the action of proteolytic enzyme - papaine (lekozime, Lek, Yugoslavia) in small doses (0.5-1.0 mg) and alcohol (in concentrations 24%, 48%, 96%) on the structure of intervertebral disks. 359 intervertebral disks were examined using light and electron microscopy. Morphologic data showed that under papaine effect the gradual substitution of the hydrated tissue of nucleus pulposus by fibrous tissue, decrease of intervertebral space and formation of not mobile block between two displaced vertebral bodies took place. Data obtained during experiments allowed to apply intradisk injection of papaine in small doses for the treatment of cervical intervertebral disk pathology, and gave the possibility to elaborate new method for the treatment of cervical osteochondrosis. That method was used in 89 patients. Follow-up period ranged from 3 months to 9 years. Positive results preserved in 95.2%o of patients. Indications and contraindications for the application of elaboration method were defined on the base of experimental and clinical data, outcomes and treatment efficacy.