Intradiscal Injection [Neurosurgery Wiki]

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====== Intradiscal Injection ======

see [[Discography]]

[[Intradiscal Platelet-Rich Plasma]]

[[Percutaneous chemonucleolysis]] with [[condoliase]] has been available for painful [[lumbar disc herniation]] since [[2018]] in [[Japan]]. Ohtonari et al. investigated clinical and radiographic [[outcome]]s three months after the administration because secondary surgical removal is most required during this period for insufficient pain relief, and analyzed whether the differences in [[intradiscal]] [[injection]] areas affected the clinical outcomes. They retrospectively investigated 47 consecutive patients (males, 31; median age, 40 years) three months after the administration. [[Clinical outcome]]s were evaluated using the Japanese Orthopaedic Association Back Pain Questionnaire (JOABPEQ), a [[visual analog scale]] (VAS) score for [[low back pain]], and VAS scores for pains and numbness in the lower limbs. Radiographic outcomes were analyzed in 41 patients, using parameters such as mid-sagittal [[disc height]] and maximal protrusion length of herniation on [[MRI]] preoperatively and at the final follow-up. The postoperative median evaluation period was 90 days. The effective rate of low back pain based on the pain-related disorders at baseline and the last follow-up in the JOABPEQ reached 79.5%. The postoperative proportion of VAS scores recovery ≥ 2 points and ≥ 50% for pains in the lower limbs were 80.9% and 66.0%, respectively, revealing satisfactory effectiveness. Preoperative median mid-sagittal disc height significantly reduced from 9.5 to 7.6 mm postoperatively. There were no significant differences in pain relief in the lower limbs by injection areas in the center and the dorsal 1/3rd near the herniation of the nucleus pulposus. Chemonucleolysis with condoliase revealed satisfactory short-term outcomes after the administration regardless of intradiscal injection areas
((Ohtonari T, Torii R, Noguchi S, Kitagawa T, Nishihara N. Short-term clinical and radiographic outcomes of [[chemonucleolysis]] with condoliase for painful lumbar disc herniation and analysis regarding intradiscal injection area. Neurosurg Rev. 2023 Feb 23;46(1):59. doi: 10.1007/s10143-023-01966-w. PMID: 36813932.))