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

Autor: Noritaka Suzuki, Yawara Eguchi, Takashi Hirai, Takuya Takahashi, Yohei Takahashi, Kota Watanabe, Tomohiro Banno, Kyohei Sakaki, Satoshi Maki, Yuuichi Takano, Yuki Taniguchi, Yasuchika Aoki, Takamitsu Konishi, Yutaka Hiraizumi, Masatsune Yamagata, Akihiro Hirakawa, Seiji Ohtori
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Asian Spine Journal, Vol 18, Iss 4, Pp 550-559 (2024)
Druh dokumentu: article
ISSN: 1976-1902
1976-7846
DOI: 10.31616/asj.2024.0042
Popis: 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: Directory of Open Access Journals
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