Complications of Pediatric and Adult Spinal Surgery
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One of the first truly minimally invasive techniques, chemonucleolysis by injection of chymopapain into the disc space, was the procedure of choice for young patients under 20 years of age with a contained herniation. Large double-blind series and numerous cohort studies validated the method introduced by Smith(7) in 1955. A few serious complications of anaphylaxis and transverse myelitis by poorly trained users caused most practitioners to shy away from the enzymatic denaturalization of the nucleus pulposus(8).