Skin Testing — The First Step to Selective Chemonucleolysis

Intradiscal injection of chymopapain has become a valuable therapeutic alternative in the treatment of lumbar disc disease (1, 4, 5, 9). Besides technical problems, which have almost completely been solved, one major concern, namely hypersensitivity to chymopapain, still remains. An easy diagnostic skin test to detect hypersensitivity to chymopapain prior to chemonucleolysis (CNL) has been reported recently (6, 7). We have been using a modified skin test routinely in our department since September 1983. This paper reports the results of the first 100 patients submitted to this test, and discusses its applicability and reliability.