Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study
Introduction: Chemonucleolysis with condoliase (chondroitin sulfate ABC endolyase) has been widely employed to treat patients with lumbar disc herniation (LDH) in Japan. Although it is an effective and relatively safe treatment for radicular neuropathy in patients with LDH, there have been no report...
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The Japanese Society for Spine Surgery and Related Research
2025-05-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0288/_pdf/-char/en |
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| author | Takashi Hirai Takuya Takahashi Yohei Takahashi Kota Watanabe Tomohiro Banno Kyohei Sakaki Yoshiyasu Arai Yuichi Takano Yawara Eguchi Yuki Taniguchi Satoshi Maki Yasuchika Aoki Shunichi Fujii Kentaro Sakaeda Yu Matsukura Tsutomu Akazawa Akihito Minamide Hidetoshi Nojiri Kenichiro Sakai Satoshi Kato Koji Tamai Hidekazu Suzuki Masayuki Miyagi Hiroyuki Sato Toshitaka Yoshii Hiroshi Yamada Takashi Kaito Yutaka Hiraizumi Masatsune Yamagata Masaya Nakamura Akihiro Hirakawa Naofumi Hosogane Seiji Ohtori |
| author_facet | Takashi Hirai Takuya Takahashi Yohei Takahashi Kota Watanabe Tomohiro Banno Kyohei Sakaki Yoshiyasu Arai Yuichi Takano Yawara Eguchi Yuki Taniguchi Satoshi Maki Yasuchika Aoki Shunichi Fujii Kentaro Sakaeda Yu Matsukura Tsutomu Akazawa Akihito Minamide Hidetoshi Nojiri Kenichiro Sakai Satoshi Kato Koji Tamai Hidekazu Suzuki Masayuki Miyagi Hiroyuki Sato Toshitaka Yoshii Hiroshi Yamada Takashi Kaito Yutaka Hiraizumi Masatsune Yamagata Masaya Nakamura Akihiro Hirakawa Naofumi Hosogane Seiji Ohtori |
| author_sort | Takashi Hirai |
| collection | DOAJ |
| description | Introduction: Chemonucleolysis with condoliase (chondroitin sulfate ABC endolyase) has been widely employed to treat patients with lumbar disc herniation (LDH) in Japan. Although it is an effective and relatively safe treatment for radicular neuropathy in patients with LDH, there have been no reports that investigate how severe low back pain (LBP) changes after condoliase injection. In this multicenter study, the effectiveness of condoliase injection for reducing severe LBP in patients with LDH was evaluated.
Methods: This retrospective study involved patients treated with intradiscal condoliase injection for LDH at nine participating centers. Patients were diagnosed with subligamentous-type herniation based on pretreatment MRI. Patients with severe LBP (defined as a preinjection numeric rating scale [NRS] for LBP greater than or equal to that for leg pain) were categorized into the LBP group. Demographic data, adverse events, treatment costs, and the NRS for LBP and lower extremity pain were analyzed. A 50% response was defined as 50% improvement in the NRS at 1 year postinjection. On the basis of the Pfirman classification, the LBP group was divided into less-degenerative (Grades II and III) and degenerative (Grades IV and V) subgroups.
Results: Seventy-nine patients were classified into the LBP group. Of these patients, 61 (77.2%) showed a >50% reduction in LBP, and another 61 (77.2%) demonstrated a >50% reduction in lower extremity pain. Improvement of lower limb pain was considerably better in the less-degenerative group than in the degenerative group, whereas that of low back pain was similar between the two subgroups. Medical costs, which include remuneration for injection, drug fees, inpatient costs, and other expenses, were similar between the LBP group and all cases.
Conclusions: This retrospective multicenter study revealed that patients with LDH with severe LBP frequently experienced improvement in radicular pain and LBP, which is similar to LDH cases without severe LBP. |
| format | Article |
| id | doaj-art-51f22f6c588e415cb7a6c9bb6ccee7d0 |
| institution | OA Journals |
| issn | 2432-261X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj-art-51f22f6c588e415cb7a6c9bb6ccee7d02025-08-20T02:34:02ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2025-05-019336837410.22603/ssrr.2024-02882024-0288Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter StudyTakashi Hirai0Takuya Takahashi1Yohei Takahashi2Kota Watanabe3Tomohiro Banno4Kyohei Sakaki5Yoshiyasu Arai6Yuichi Takano7Yawara Eguchi8Yuki Taniguchi9Satoshi Maki10Yasuchika Aoki11Shunichi Fujii12Kentaro Sakaeda13Yu Matsukura14Tsutomu Akazawa15Akihito Minamide16Hidetoshi Nojiri17Kenichiro Sakai18Satoshi Kato19Koji Tamai20Hidekazu Suzuki21Masayuki Miyagi22Hiroyuki Sato23Toshitaka Yoshii24Hiroshi Yamada25Takashi Kaito26Yutaka Hiraizumi27Masatsune Yamagata28Masaya Nakamura29Akihiro Hirakawa30Naofumi Hosogane31Seiji Ohtori32Department of Orthopedics, Institute of Science TokyoDepartment of Orthopedics, Institute of Science TokyoDepartment of Orthopedic Surgery, Keio UniversityDepartment of Orthopedic Surgery, Keio UniversityDepartment of Orthopaedic Surgery, Hamamatsu Univerisity School of MedicineDepartment of Orthopaedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopaedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Inanami Spine and Joint HospitalDepartment of Orthopaedic Surgery, Tokyo Joto HospitalDepartment of Orthopedic Surgery, The University of TokyoDepartment of Orthopedic Surgery, Chiba UniversityDepartment of Orthopaedic Surgery, Eastern Chiba Medical CenterDepartment of Orthopedics, Institute of Science TokyoDepartment of Orthopedics, Institute of Science TokyoDepartment of Orthopedics, Institute of Science TokyoDepartment of Orthopaedic Surgery, St. Marianna University School of MedicineDepartment of Orthopaedic Surgery, Dokkyo Medical University Nikko Medical CenterDepartment of Orthopedic Surgery, Juntendo UniversityDepartment of Orthopaedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopaedic Surgery, Kanazawa UniversityDepartment of Orthopedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Orthopedics, Institute of Science TokyoDepartment of Orthopedic Surgery, Wakayama Medical UniversityDepartment of Orthopaedic Surgery, Osaka Rosai HospitalDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Oyuminochuobyoin Mobara ClinicDepartment of Orthopedic Surgery, Keio UniversityDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Orthopaedic Surgery, Kyorin UniversityDepartment of Orthopedic Surgery, Chiba UniversityIntroduction: Chemonucleolysis with condoliase (chondroitin sulfate ABC endolyase) has been widely employed to treat patients with lumbar disc herniation (LDH) in Japan. Although it is an effective and relatively safe treatment for radicular neuropathy in patients with LDH, there have been no reports that investigate how severe low back pain (LBP) changes after condoliase injection. In this multicenter study, the effectiveness of condoliase injection for reducing severe LBP in patients with LDH was evaluated. Methods: This retrospective study involved patients treated with intradiscal condoliase injection for LDH at nine participating centers. Patients were diagnosed with subligamentous-type herniation based on pretreatment MRI. Patients with severe LBP (defined as a preinjection numeric rating scale [NRS] for LBP greater than or equal to that for leg pain) were categorized into the LBP group. Demographic data, adverse events, treatment costs, and the NRS for LBP and lower extremity pain were analyzed. A 50% response was defined as 50% improvement in the NRS at 1 year postinjection. On the basis of the Pfirman classification, the LBP group was divided into less-degenerative (Grades II and III) and degenerative (Grades IV and V) subgroups. Results: Seventy-nine patients were classified into the LBP group. Of these patients, 61 (77.2%) showed a >50% reduction in LBP, and another 61 (77.2%) demonstrated a >50% reduction in lower extremity pain. Improvement of lower limb pain was considerably better in the less-degenerative group than in the degenerative group, whereas that of low back pain was similar between the two subgroups. Medical costs, which include remuneration for injection, drug fees, inpatient costs, and other expenses, were similar between the LBP group and all cases. Conclusions: This retrospective multicenter study revealed that patients with LDH with severe LBP frequently experienced improvement in radicular pain and LBP, which is similar to LDH cases without severe LBP.https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0288/_pdf/-char/enintradiscal injectioncondoliasechemonucleolysislumbar intervertebral disc herniationradiculopathyleg painlow back painmedical cost |
| spellingShingle | Takashi Hirai Takuya Takahashi Yohei Takahashi Kota Watanabe Tomohiro Banno Kyohei Sakaki Yoshiyasu Arai Yuichi Takano Yawara Eguchi Yuki Taniguchi Satoshi Maki Yasuchika Aoki Shunichi Fujii Kentaro Sakaeda Yu Matsukura Tsutomu Akazawa Akihito Minamide Hidetoshi Nojiri Kenichiro Sakai Satoshi Kato Koji Tamai Hidekazu Suzuki Masayuki Miyagi Hiroyuki Sato Toshitaka Yoshii Hiroshi Yamada Takashi Kaito Yutaka Hiraizumi Masatsune Yamagata Masaya Nakamura Akihiro Hirakawa Naofumi Hosogane Seiji Ohtori Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study Spine Surgery and Related Research intradiscal injection condoliase chemonucleolysis lumbar intervertebral disc herniation radiculopathy leg pain low back pain medical cost |
| title | Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study |
| title_full | Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study |
| title_fullStr | Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study |
| title_full_unstemmed | Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study |
| title_short | Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study |
| title_sort | clinical and economic outcomes of intradiscal injection of condoliase for a treatment of lumbar disc herniation with severe low back pain a multicenter study |
| topic | intradiscal injection condoliase chemonucleolysis lumbar intervertebral disc herniation radiculopathy leg pain low back pain medical cost |
| url | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0288/_pdf/-char/en |
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