Chemonucleolysis:

This procedure is performed in the hospital, typically on an outpatient basis. It is performed under intravenous sedation.  Your pain physician uses a proprietary blend of dextrose, chondroitin, glucosamine, DMSO, bupivacaine and antibiotic rather than traditional chymopapain. As opposed to chymopapain, this mixture does not traditionally induce a significant risk of anaphylaxis (a severe allergic reaction).

With the individual correctly positioned on the procedure table, a needle is inserted through the skin into the gel-like inner material (nucleus pulposus) of the intervertebral disc. The position of the needle is critical. Its placement in the center of the disc is visually confirmed with C-arm fluoroscopy (x-ray). Once needle placement is confirmed, the disc is injected with the proprietary mixture and the needles removed.


Dr. Spiel’s unique clinical background has enabled him to view the practice of interventional pain through a broader perspective...

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