Outcome of intradiscal condoliase injection therapy for patients with recurrent lumbar disc herniation.

Autor: Suzuki N; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.; Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Japan., Eguchi Y; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.; Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Japan., Hirai T; Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Takahashi T; Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Takahashi Y; Department of Orthopaaedic Surgery, Keio University School of Medicine, Tokyo, Japan., Watanabe K; Department of Orthopaaedic Surgery, Keio University School of Medicine, Tokyo, Japan., Banno T; Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan., Sakaki K; Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan., Maki S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Takano Y; Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan., Taniguchi Y; Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan., Aoki Y; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Japan., Konishi T; Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan., Hiraizumi Y; Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan., Yamagata M; Department of Orthopaedic Surgery, Oyumino Central Hospital Mobara Clinic, Mobara, Japan., Hirakawa A; Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Ohtori S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Jazyk: angličtina
Zdroj: Asian spine journal [Asian Spine J] 2024 Aug; Vol. 18 (4), pp. 550-559. Date of Electronic Publication: 2024 Aug 08.
DOI: 10.31616/asj.2024.0042
Abstrakt: Study Design: Retrospective cohort study.
Purpose: This study aimed to compare data from patients who received intradiscal condoliase (chondroitin sulfate ABC endolyase) injection for primary lumbar disc herniation (LDH) and recurrent LDH.
Overview of Literature: Chemonucleolysis with condoliase for LDH is a treatment with relatively good results and a high safety profile; however, few studies have reported recurrence after LDH surgery.
Methods: The study participants were 249 patients who underwent intradiscal condoliase injection for LDH at nine participating institutions, including 241 patients with initial LDH (group C) and eight with recurrent LDH (group R). Patient characteristics including age, sex, body mass index, disease duration, intervertebral LDH level, smoking history, and diabetes history were evaluated. Low back pain/leg pain Numerical Rating Scale (NRS) scores and the Oswestry Disability Index (ODI) were used to evaluate clinical symptoms before treatment and at 6 months and 1 year after treatment.
Results: Low back pain NRS scores (before treatment and at 6 months and 1 year after treatment, respectively) in group C (4.9 → 2.6 → 1.8) showed significant improvement until 1 year after treatment. Although a tendency for improvement was observed in group R (3.5 → 2.8 → 2.2), no significant difference was noted. Groups C (6.6 → 2.4 → 1.4) and R (7.0 → 3.1 → 3.2) showed significant improvement in the leg pain NRS scores after treatment. Group C (41.4 → 19.5 → 13.7) demonstrated significant improvement in the ODI up to 1 year after treatment; however, no significant difference was found in group R (35.7 → 31.7 → 26.4).
Conclusions: Although intradiscal condoliase injection is less effective for LDH recurrence than for initial cases, it is useful for improving leg pain and can be considered a minimally invasive and safe treatment method.
Databáze: MEDLINE
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