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Utilization of condoliase therapy versus surgery for lumbar disc herniation and comparison of post-treatment motor improvement.
Fujimoto, Kazuhiro; Suzuki, Hidenori; Nishida, Norihiro; Funaba, Masahiro; Ichihara, Yusuke; Ikeda, Hiroaki; Imajo, Yasuaki; Yamamoto, Manabu; Sakai, Takashi.
Afiliación
  • Fujimoto K; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Department of Orthopedic Surgery, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan. Electronic address: kafuji@yamaguchi-u.ac.jp.
  • Suzuki H; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
  • Nishida N; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
  • Funaba M; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
  • Ichihara Y; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Department of Orthopedic Surgery, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.
  • Ikeda H; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Department of Orthopedic Surgery, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.
  • Imajo Y; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Department of Orthopedic Surgery, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.
  • Yamamoto M; Department of Orthopedic Surgery, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.
  • Sakai T; Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Clin Neurol Neurosurg ; 246: 108544, 2024 Sep 12.
Article en En | MEDLINE | ID: mdl-39270464
ABSTRACT
STUDY

DESIGN:

Double-center retrospective study.

PURPOSE:

Utilization trends in interventional treatment for lumbar disc herniation (LDH) have not yet been examined. Furthermore, limited information is currently available on motor recovery with condoliase therapy. Therefore, the present study investigated utilization trends in treatment for LDH and the effects of condoliase therapy on muscle weakness.

METHODS:

This retrospective, double-center study involved patients with leg pain caused by LDH who received interventional treatment between September 2017 and August 2022. LDH patients were divided into two groups an operative treatment group and condoliase therapy group. The period between September 2017 and August 2022 was divided into 5 equal parts and changes in the percentage of intervention treatment were examined. Motor recovery was also assessed in the two groups. Patients receiving condoliase therapy were divided into two groups an effective group and non-effective group. Sex, age, the body mass index, duration of symptoms, herniation level, neurological and radiographic findings, a visual analog scale for leg pain, and the Oswestry disability index were examined in the two groups.

RESULTS:

Subjects included 226 males and 115 females with a mean age of 49.2 years, mean BMI of 22.8, and mean duration of symptoms of 5.0 months. The utilization of condoliase therapy for LDH surpassed surgery in the third year after its introduction. In the fourth year, condoliase therapy became the main treatment for LDH. Lower limb muscle strength improved in 76 % of cases receiving condoliase therapy.

CONCLUSIONS:

Condoliase therapy has become an intermediate treatment before surgery in our institutions. Motor recovery in patients receiving condoliase therapy was not inferior to that after surgery; however, in cases with severe muscle weakness with manual muscle test ≤3, the improvement rate was approximately 60 %. These results will be useful for clinicians when providing informed consent and selecting condoliase therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos