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Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation

Background and Objectives: Condoliase, a chondroitin sulfate ABC endolyase, is a novel and minimally invasive chemonucleolytic drug for lumbar disc herniation. Despite the growing number of treatments for lumbar disc herniation, the predicting factors for poor outcomes following treatment remain unc...

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Autores principales: Takeuchi, Shu, Hanakita, Junya, Takahashi, Toshiyuki, Inoue, Tomoo, Minami, Manabu, Suda, Izumi, Nakamura, Sho, Kanematsu, Ryo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781337/
https://www.ncbi.nlm.nih.gov/pubmed/36557070
http://dx.doi.org/10.3390/medicina58121868
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author Takeuchi, Shu
Hanakita, Junya
Takahashi, Toshiyuki
Inoue, Tomoo
Minami, Manabu
Suda, Izumi
Nakamura, Sho
Kanematsu, Ryo
author_facet Takeuchi, Shu
Hanakita, Junya
Takahashi, Toshiyuki
Inoue, Tomoo
Minami, Manabu
Suda, Izumi
Nakamura, Sho
Kanematsu, Ryo
author_sort Takeuchi, Shu
collection PubMed
description Background and Objectives: Condoliase, a chondroitin sulfate ABC endolyase, is a novel and minimally invasive chemonucleolytic drug for lumbar disc herniation. Despite the growing number of treatments for lumbar disc herniation, the predicting factors for poor outcomes following treatment remain unclear. The aim of this study was to determine the predictive factors for unsuccessful clinical outcome following condoliase therapy. Material and Methods: We performed a retrospective single-center analysis of 101 patients who underwent chemonucleolysis with condoliase from January 2019 to December 2021. Patients were divided into good outcome (i.e., favorable outcome) and poor outcome (i.e., requiring additional surgical treatment) groups. Patient demographics and imaging findings were collected. Clinical outcomes were evaluated using the numerical rating scale and Japanese Orthopaedic Association scores at baseline and at 1- and 3-month follow-up. Pretreatment indicators for additional surgery were compared between the 2 groups. Results: There was a significant difference in baseline leg numbness between the good outcome and poor outcome groups (6.27 ± 1.90 vs. 4.42 ± 2.90, respectively; p = 0.033). Of the 101 included patients, 32 received a preoperative computed tomography scan. In those patients, the presence of calcification or ossification in disc hernia occurred more often in the poor outcome group (61.5% vs. 5.3%, respectively; p < 0.001; odds ratio = 22.242; p = 0.014). Receiver-operating characteristics curve analysis for accompanying calcification or ossification showed an area under the curve of 0.858 (95% confidence interval, 0.715–1.000; p = 0.001). Conclusions: Calcified or ossified disc herniation may be useful predictors of unsuccessful treatment in patients with condoliase administration.
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spelling pubmed-97813372022-12-24 Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation Takeuchi, Shu Hanakita, Junya Takahashi, Toshiyuki Inoue, Tomoo Minami, Manabu Suda, Izumi Nakamura, Sho Kanematsu, Ryo Medicina (Kaunas) Article Background and Objectives: Condoliase, a chondroitin sulfate ABC endolyase, is a novel and minimally invasive chemonucleolytic drug for lumbar disc herniation. Despite the growing number of treatments for lumbar disc herniation, the predicting factors for poor outcomes following treatment remain unclear. The aim of this study was to determine the predictive factors for unsuccessful clinical outcome following condoliase therapy. Material and Methods: We performed a retrospective single-center analysis of 101 patients who underwent chemonucleolysis with condoliase from January 2019 to December 2021. Patients were divided into good outcome (i.e., favorable outcome) and poor outcome (i.e., requiring additional surgical treatment) groups. Patient demographics and imaging findings were collected. Clinical outcomes were evaluated using the numerical rating scale and Japanese Orthopaedic Association scores at baseline and at 1- and 3-month follow-up. Pretreatment indicators for additional surgery were compared between the 2 groups. Results: There was a significant difference in baseline leg numbness between the good outcome and poor outcome groups (6.27 ± 1.90 vs. 4.42 ± 2.90, respectively; p = 0.033). Of the 101 included patients, 32 received a preoperative computed tomography scan. In those patients, the presence of calcification or ossification in disc hernia occurred more often in the poor outcome group (61.5% vs. 5.3%, respectively; p < 0.001; odds ratio = 22.242; p = 0.014). Receiver-operating characteristics curve analysis for accompanying calcification or ossification showed an area under the curve of 0.858 (95% confidence interval, 0.715–1.000; p = 0.001). Conclusions: Calcified or ossified disc herniation may be useful predictors of unsuccessful treatment in patients with condoliase administration. MDPI 2022-12-18 /pmc/articles/PMC9781337/ /pubmed/36557070 http://dx.doi.org/10.3390/medicina58121868 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Takeuchi, Shu
Hanakita, Junya
Takahashi, Toshiyuki
Inoue, Tomoo
Minami, Manabu
Suda, Izumi
Nakamura, Sho
Kanematsu, Ryo
Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title_full Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title_fullStr Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title_full_unstemmed Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title_short Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation
title_sort predictive factors for poor outcome following chemonucleolysis with condoliase in lumbar disc herniation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781337/
https://www.ncbi.nlm.nih.gov/pubmed/36557070
http://dx.doi.org/10.3390/medicina58121868
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