盘内注射condoliase后椎间盘特性的详细变化仍存在争议。给药后3个月和9个月,研究了椎间盘的影像学变化。共有41名患者(男性,25岁;平均年龄,46年),在未进行其他侵入性治疗的情况下,在给药后3和9个月进行了定期随访磁共振成像。基于Pfirrmann椎间盘分级系统的髓核强度变化,中矢状椎间盘高度,并评估了疝的最大突出长度。此外,比较了24例年龄<50岁的患者(年轻组)和17例年龄≥50岁的患者(50岁以上组)的椎间盘高度变化.术前椎间盘的整体平均高度分别为9.1、7.5和7.6mm,3个月时,9个月时,分别,3个月时显著降低(P<0.001),此后无显著变化。疝的平均最大突出长度显着并逐渐减少。给药后Pfirrmann椎间盘等级的总比例在3到9个月之间相等。然而,在3至9个月之间,17例中有8例(47.1%)确认了从Pfirrmann椎间盘IV至III级的恢复,20例中有6例(30.0%)显示从III到IV的下降。与50岁以上组相比,治疗前椎间盘高度>11mm的年轻组患者的椎间盘高度降低最大。总之,在50岁以上组的临床结果与年轻组注射condoliase后的结果相当,而椎间盘较高的年轻患者更容易发生椎间盘高度降低。
The detailed changes in disc properties after intradiscal injection of condoliase remain controversial. At 3 and 9 months after administration, radiographic changes in discs were investigated. A total of 41 patients (men, 25; median age, 46 years) who underwent regular follow-up magnetic resonance imaging at 3 and 9 months after administration without additional invasive therapy were retrospectively investigated. The intensity changes of the nucleus pulposus based on the Pfirrmann disc grading system, midsagittal disc height, and maximum protrusion length of herniation were assessed. In addition, disc height changes were compared between 24 patients aged <50 years (young group) and 17 patients aged ≥50 years (over 50s group). The overall mean disc heights were 9.1, 7.5, and 7.6 mm preoperatively, at 3 months, and at 9 months, respectively, with a significant reduction at 3 months (P < 0.001) and no significant changes thereafter. The mean maximum protrusion length of herniation significantly and gradually decreased. The overall proportions of Pfirrmann disc grades after administration were equivalent between 3 and 9 months. However, the recovery from Pfirrmann disc grades IV to III was confirmed in 8 of 17 cases (47.1%) between 3 and 9 months, whereas 6 of 20 cases (30.0%) showed a decline from III to IV. Patients in the young group with pretreatment disc height >11 mm had the greatest reduction in disc height than the over 50s group. In conclusion, the clinical outcomes in the over 50s group were comparable to those in the young group after injection of condoliase, whereas young patients with higher disc were more susceptible to disc height reduction.