0
January 2, 1987, Vol 257, No. 1 >

Full Content is available to subscribers

Subscribe/Learn More
ARTICLE | January 2, 1987

Chemonucleolysis and Microsurgery for Lumbar Disk Disease

John A. McCulloch, MD
JAMA. 1987;257(1):28. doi:10.1001/jama.1987.03390010032016.
Text Size: A A A
Published online
Article
References

To the Editor.—  It is unfortunate that the article by Beverly Merz1 did not include some important points. Given that, I agree that surgeons who do not grasp the indications for and technical factors involved in chemonucleolysis will not get good results, may cause complications, and should give up the procedure.The setback to chemonucleolysis in North America occurred because of poor training of surgeons—the effort to train surgeons was so massive and so sudden that at best their skills were immature. Is it any wonder that a number of technical problems occurred with chymopapain injection?The patient with a soft-disk herniation causing sciatica who will respond to a chymopapain injection has relatively severe pain in the leg (compared with back pain) and has marked reduction of straight-leg raising, as well as neurological symptoms and signs. I am sure that Dr Shields would quickly admit that his series did

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Letters

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs

More Listings at
JAMACareerCenter.com >

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems