PDF(Pubmed)
Abstract：
METHODS: Retrospective cohort study.
OBJECTIVE: 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.
BACKGROUND: 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.
OBJECTIVE: 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.
BACKGROUND: 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.
摘要：
■回顾性队列研究。
■本研究旨在比较接受椎间盘内糖酶（硫酸软骨素ABC内溶酶）注射治疗原发性腰椎间盘突出症（LDH）和复发性LDH的患者的数据。
■用condoliase进行LDH的化学核酸溶解是一种效果相对较好且安全性较高的治疗方法；然而，很少有研究报道LDH手术后复发。
■研究参与者是249名患者，他们在9个参与机构接受了椎间盘内注射LDH，包括241例初始LDH患者（C组）和8例复发LDH患者（R组）。患者特征包括年龄,性别,身体质量指数,疾病持续时间,椎间LDH水平,吸烟史,并评估糖尿病史。采用腰背痛/腿痛数值评定量表(NRS)评分和Oswestry残疾指数(ODI)对治疗前、治疗后6个月和1年的临床症状进行评估。
■下腰痛NRS评分（治疗前以及治疗后6个月和1年，分别）在C组（4.9→2.6→1.8）中显示出显着改善，直到治疗后1年。尽管在R组中观察到了改善的趋势（3.5→2.8→2.2），没有发现显著差异。C组（6.6→2.4→1.4）和R组（7.0→3.1→3.2）治疗后腿部疼痛NRS评分显着改善。C组（41.4→19.5→13.7）在治疗后1年内表现出ODI的显著改善；然而，R组差异无统计学意义(35.7→31.7→26.4)。
■尽管椎间盘内注射对LDH复发的疗效不如初始病例，它对改善腿部疼痛很有用，可以被认为是一种微创和安全的治疗方法。
■本研究旨在比较接受椎间盘内糖酶（硫酸软骨素ABC内溶酶）注射治疗原发性腰椎间盘突出症（LDH）和复发性LDH的患者的数据。
■用condoliase进行LDH的化学核酸溶解是一种效果相对较好且安全性较高的治疗方法；然而，很少有研究报道LDH手术后复发。
■研究参与者是249名患者，他们在9个参与机构接受了椎间盘内注射LDH，包括241例初始LDH患者（C组）和8例复发LDH患者（R组）。患者特征包括年龄,性别,身体质量指数,疾病持续时间,椎间LDH水平,吸烟史,并评估糖尿病史。采用腰背痛/腿痛数值评定量表(NRS)评分和Oswestry残疾指数(ODI)对治疗前、治疗后6个月和1年的临床症状进行评估。
■下腰痛NRS评分（治疗前以及治疗后6个月和1年，分别）在C组（4.9→2.6→1.8）中显示出显着改善，直到治疗后1年。尽管在R组中观察到了改善的趋势（3.5→2.8→2.2），没有发现显著差异。C组（6.6→2.4→1.4）和R组（7.0→3.1→3.2）治疗后腿部疼痛NRS评分显着改善。C组（41.4→19.5→13.7）在治疗后1年内表现出ODI的显著改善；然而，R组差异无统计学意义(35.7→31.7→26.4)。
■尽管椎间盘内注射对LDH复发的疗效不如初始病例，它对改善腿部疼痛很有用，可以被认为是一种微创和安全的治疗方法。
