"Advancements in minimally invasive treatment for lumbar disc herniation: insights into condoliase and chondroitin sulfate ABC endolyase".

Chemonucleolysis Chondroitin sulfate ABC endolyase Condoliase chemonucleolysis (CC) Intradiscal condoliase injection Lumbar disc herniation (LDH) Minimally invasive treatment Nucleus pulposus Pain relief

Journal

Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181

Informations de publication

Date de publication:
06 Sep 2024
Historique:
received: 22 08 2024
accepted: 01 09 2024
revised: 22 08 2024
medline: 6 9 2024
pubmed: 6 9 2024
entrez: 5 9 2024
Statut: epublish

Résumé

This study examines the efficacy and safety of condoliase chemonucleolysis (CC) in treating lumbar disc herniation (LDH) and highlights emerging alternatives like chondroitin sulfate ABC endolyase. Research indicates that condoliase, an enzyme used to degrade glycosaminoglycans in the nucleus pulposus, provides effective and prompt relief of leg pain, with significant reductions observed within a day of treatment. Studies reveal that a lower pretreatment straight leg raising (SLR) angle may predict early symptom relief, and condoliase is generally effective at doses up to 1.25 U, balancing efficacy and safety. Despite promising results, concerns about long-term safety, including disc height reduction and imaging changes, persist. Additionally, chondroitin sulfate ABC endolyase shows potential as a safer and more effective alternative, though further research is needed to optimize treatment protocols and assess long-term outcomes. Future investigations should address current limitations, such as small sample sizes and short follow-up periods, to better understand the long-term benefits and risks of these treatments.

Identifiants

pubmed: 39237740
doi: 10.1007/s10143-024-02811-4
pii: 10.1007/s10143-024-02811-4
doi:

Substances chimiques

Chondroitin ABC Lyase EC 4.2.2.20

Types de publication

Journal Article Review Letter

Langues

eng

Sous-ensembles de citation

IM

Pagination

553

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Kamatani T, Kitaguchi K, Kashii M (Aug. 2024) Characteristics in patients with very early therapeutic response of condoliase chemonucleolysis for lumbar disc herniation. Neurosurg Rev 47(1):422. https://doi.org/10.1007/s10143-024-02640-5
Matsuyama Y, Chiba K, Iwata H, Seo T, Toyama Y (May 2018) A multicenter, randomized, double-blind, dose-finding study of condoliase in patients with lumbar disc herniation. J Neurosurg Spine 28(5):499–511. https://doi.org/10.3171/2017.7.SPINE161327
Nakajima H, Watanabe S, Honjoh K, Kubota A, Matsumine A (2024) Indication and Limitation of Intradiscal Condoliase Injection for Patients with Lumbar Disc Herniation: Literature Review and Meta-Analysis., Spine Surg Relat Res, vol. 8, no. 4, pp. 362–372, Jul. https://doi.org/10.22603/ssrr.2023-0294
Matsuyama Y, Seo T, Chiba K (2023) Condoliase chemonucleolysis for lumbar disc herniation: A post-hoc follow-up study of patients in previous clinical trials., J Orthop Sci, vol. 28, no. 4, pp. 724–732, Jul. https://doi.org/10.1016/j.jos.2022.04.003
Ishibashi K, Iwai H, Koga H (Jun. 2019) Chemonucleolysis with chondroitin sulfate ABC endolyase as a novel minimally invasive treatment for patients with lumbar intervertebral disc herniation. J Spine Surg 5:S115–S121. https://doi.org/10.21037/jss.2019.04.24

Auteurs

Manal Nadeem (M)

Islamic International Medical College, Rawalpindi, Pakistan. drmanalnadeem@gmail.com.

Maria Farooq (M)

Islamic International Medical College, Rawalpindi, Pakistan.

Haiqa Khalil (H)

Islamic International Medical College, Rawalpindi, Pakistan.

Sajjal Fatima (S)

Islamic International Medical College, Rawalpindi, Pakistan.

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Classifications MeSH