Twenty-nine patients with persistent, low back and sciatic pain received intradiscal collagenase at a single abnormal disk space after two months of conservative therapy and two weeks of additional bed rest. Complete pain relief was achieved in six patients (21%), notable relief in 12 (42%), moderate in six (21%), and slight in one. Four patients (14%) who obtained no improvement by enzyme injection recovered after extruded disk fragments were removed from the spinal canal during a later operation. Pain relief after collagenase injection took place gradually over a two- to three-week period and was associated with some early backache. Improvement then continued at a slower rate for two to three months. There were no adverse effects of enzyme therapy. Injected disk spaces usually showed radiological narrowing.
Sussman BJ, Bromley JW, Gomez JC. Injection of Collagenase in the Treatment of Herniated Lumbar DiskInitial Clinical Report. JAMA. 1981;245(7):730-732. doi:10.1001/jama.1981.03310320052026