Effect of Collagenase Chemonucleolysis on Residual Pain After Transforaminal Lumbar Endoscopic Discectomy

Abstract

Purpose

To investigate the short-term clinical effect of collagenase chemonucleolysis (CCNL) in the treatment of residual pain after transforaminal lumbar endoscopic discectomy (TLED).

Patients and Methods

The clinical data of 40 patients with residual pain after TLED for lumbar disc herniation (LDH) in our hospital from January 2018 to December 2020 were retrospectively analyzed. The visual analogue scale (VAS) and quality of recovery-15 (QoR-15) were used to evaluate the effect of the operation. Modified MacNab method was used to evaluate the efficacy of CCNL at 6 months and 12 months after operation.

Results

All patients successfully completed the operation without serious complications, such as intervertebral space infection, vascular injury and nerve injury. The VAS 3 days after TLED was not significantly lower than that Pre-TLED (P > 0.05). The VAS at each time point after CCNL was significantly lower than that at Pre-TLED, and the QoR-15 score at each time point after CCNL was significantly higher than that 3 days after CCNL (P < 0.05). The modified MacNab criteria for the last follow-up was 95%.

Conclusion

CCNL can effectively relieve the residual pain after TLED, and the quality of life of patients after TLED is improved with time, and the safety of CCNL is higher.

Keywords:

• collagenase chemonucleolysis
• transforaminal lumbar endoscopic discectomy
• lumbar disc herniation
• pain
• quality of recovery

Abbreviations

CCNL, collagenase chemonucleolysis; TLED, transforaminal lumbar endoscopic discectomy; VAS, visual analogue scale; QoR-15, quality of recovery-15; LDH, Lumbar disc herniation; ECG, electrocardiogram; BMI, body mass index; CN, coblation nucleoplasty; FS, foraminal stenosis; ADS, adult degenerative scoliosis; RFS, recurrent foraminal stenosis; ASD, adjacent segment disease; PLA2, phospholipase A2.

Data Sharing Statement

All the processed data were included in the current study. If reviewers or readers have any questions regarding our published data, they can contact the corresponding author [email, [email protected]] for access to the original data.

Acknowledgments

We thank all those who supported and participated in the study, including our staff, patients and their family members.

Disclosure

The authors report no conflicts of interest in this work.