Abstract：
Background and Objectives: Condoliase, a chondroitin sulfate ABC endolyase, is a novel and minimally invasive chemonucleolytic drug for lumbar disc herniation. Despite the growing number of treatments for lumbar disc herniation, the predicting factors for poor outcomes following treatment remain unclear. The aim of this study was to determine the predictive factors for unsuccessful clinical outcome following condoliase therapy. Material and Methods: We performed a retrospective single-center analysis of 101 patients who underwent chemonucleolysis with condoliase from January 2019 to December 2021. Patients were divided into good outcome (i.e., favorable outcome) and poor outcome (i.e., requiring additional surgical treatment) groups. Patient demographics and imaging findings were collected. Clinical outcomes were evaluated using the numerical rating scale and Japanese Orthopaedic Association scores at baseline and at 1- and 3-month follow-up. Pretreatment indicators for additional surgery were compared between the 2 groups. Results: There was a significant difference in baseline leg numbness between the good outcome and poor outcome groups (6.27 ± 1.90 vs. 4.42 ± 2.90, respectively; p = 0.033). Of the 101 included patients, 32 received a preoperative computed tomography scan. In those patients, the presence of calcification or ossification in disc hernia occurred more often in the poor outcome group (61.5% vs. 5.3%, respectively; p < 0.001; odds ratio = 22.242; p = 0.014). Receiver-operating characteristics curve analysis for accompanying calcification or ossification showed an area under the curve of 0.858 (95% confidence interval, 0.715−1.000; p = 0.001). Conclusions: Calcified or ossified disc herniation may be useful predictors of unsuccessful treatment in patients with condoliase administration.
摘要：
背景和目标：Condoliase，硫酸软骨素ABC内溶酶，是一种治疗腰椎间盘突出症的新型微创化学溶核药物。尽管腰椎间盘突出症的治疗方法越来越多,治疗后不良结局的预测因素尚不清楚.这项研究的目的是确定condoliase治疗后不成功的临床结果的预测因素。材料和方法：我们对2019年1月至2021年12月进行了一次回顾性单中心分析的101例患者进行了化学核溶解术。患者被分为良好的结果(即，有利的结果)和较差的结果(即，需要额外的手术治疗)组。收集患者的人口统计学和影像学发现。在基线和随访1个月和3个月时，使用数字评定量表和日本骨科协会评分评估临床结果。比较2组额外手术的治疗前指标。结果：良好结果组和不良结果组之间的基线腿部麻木存在显着差异（6.27±1.90vs.分别为4.42±2.90；p=0.033）。在101名患者中，32人接受了术前计算机断层扫描。在这些患者中，椎间盘疝钙化或骨化的发生更常见于不良结局组(61.5%vs.5.3%,分别为；p<0.001；比值比=22.242；p=0.014）。伴随钙化或骨化的受试者工作特征曲线分析显示曲线下面积为0.858（95％置信区间，0.715-1.000；p=0.001）。结论：骨化或骨化的椎间盘突出症可能是使用condoliase的患者治疗失败的有用预测因素。
