Asian Spine J.
2024 Aug;18(4):550-559. 10.31616/asj.2024.0042.
Outcome of intradiscal condoliase injection therapy for patients with recurrent lumbar disc herniation
- Suzuki N
1,2 - Eguchi Y1,2
- Hirai T3
- Takahashi T3
- Takahashi Y4
- Watanabe K4
- Banno T5
- Sakaki K6
- Maki S1
- Takano Y7
- Taniguchi Y8
- Aoki Y9
- Konishi T10
- Hiraizumi Y11
- Yamagata M12
- Hirakawa A13
- Ohtori S1
- Affiliations
-
- 1Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
- 2Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Japan
- 3Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- 4Department of Orthopaaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- 5Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
- 6Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
- 7Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan
- 8Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
- 9Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Japan
- 10Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
- 11Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
- 12Department of Orthopaedic Surgery, Oyumino Central Hospital Mobara Clinic, Mobara, Japan
- 13Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- KMID: 2558828
- DOI: http://doi.org/10.31616/asj.2024.0042
Abstract
- 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.
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