2024 Volume 15 Issue 4 Pages 713-720
OBJECTIVE: We investigated whether condoliase-induced chemonucleolysis could be a conservative treatment to avoid surgery in the treatment of lumbar disc herniation.
Methods: 83 patients with herniated discs with Pfirrmann grade III or higher who were treated with intradiscal condoliase injection therapies and observed for more than 6 months were analyzed. Nerve root blocks were preferentially selected for painful patients who resisted conservative treatments, and condoliase injection therapies were recommended for patients who still did not improve. History at before the procedure and 2 weeks, 4 months, 6 months, 12 months after the procedure were analyzed. MRI at before the procedure and 4 months, 6 months, 12 months after the procedure were analyzed.
Results: (1) Condoliase injection therapies showed that the onset of effect were as early as 2 weeks, and 92% of improvements of final arriable points were reached at 6 months, and symptoms improved until 1 year. (2) Dropout operative cases in other hospitals were added as poor performers. Our results showed an efficacy rate of 79%, with 3 cases requiring surgery. (3) MRI showed hernia reductions in 77% of patients. In cases where even partial hernia reductions were observed, good results were expected in 89% of the cases. (4) Spinal canal stenosis, multiple vertebral disc disorders, instability, past surgery, and heavy labor were associated with poor results. (5) Intervertebral disc height decreased to 85% after enzyme injection and recovered to 93% after 1 year, compared with the initial height.
Conclusion: Condoliase injection therapy may be the next non-surgical treatment of choice for patients even with moderate disc degeneration if risk factors such as spinal canal stenosis, multiple intervertebral disc disorders, instability, past surgery, and heavy labor are avoided.
