The clinical findings from 83 cases treated with intradiscal condoliase injection therapy for lumbar disc herniations
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- Sakaeda Hirofumi
- Matsuoka Orthopedics, Internal Medicine, and Rehabilitation Department of Orthopedic Surgery, formerly Midori Municipal Hospital
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- Matsuoka Yuji
- Matsuoka Orthopedics, Internal Medicine, and Rehabilitation
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- Matsuoka Tatsuki
- Matsuoka Orthopedics, Internal Medicine, and Rehabilitation
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- Hattori Akinori
- Kyoto Knee Osteoarthiritis Clinic Department of Orthopedic Surgery, formerly Midori Municipal Hospital
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- Fukaya Hideaki
- Department of Orthopedic Surgery, Meiho Hospital Department of Orthopedic Surgery, formerly Midori Municipal Hospital
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- Kawakami Tarou
- Taro Orthopedic Clinic
Bibliographic Information
- Other Title
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- 椎間板内condoliase注入療法施行例から知り得たいくつかの知見について
Abstract
<p>OBJECTIVE: We investigated whether condoliase-induced chemonucleolysis could be a conservative treatment to avoid surgery in the treatment of lumbar disc herniation.</p><p>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.</p><p>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.</p><p>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.</p>
Journal
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- Journal of Spine Research
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Journal of Spine Research 15 (4), 713-720, 2024-04-20
The Japanese Society for Spine Surgery and Related Research
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Details 詳細情報について
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- CRID
- 1390018428978390144
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- ISSN
- 24351563
- 18847137
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- Text Lang
- ja
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- Data Source
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- JaLC
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- Abstract License Flag
- Disallowed