Disc degeneration could be recovered after chemonucleolysis with condoliase.-1 year clinical outcome of condoliase therapy-

Banno, Tomohiro; Hasegawa, Tomohiko; Yamato, Yu; Yoshida, Go; Arima, Hideyuki; Oe, Shin; Mihara, Yuki; Yamada, Tomohiro; Ide, Koichiro; Watanabe, Yasuhide; Kurosu, Kenta; Nakai, Keiichi; Matsuyama, Yukihiro

doi:10.1016/j.jos.2021.05.005

Cited by 18 publications

(34 citation statements)

References 25 publications

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“…Moreover, patients with disc height recovery had a higher incidence of recovery based on Pfirrmann grading, compared to those without disc height recovery. 19 …”

Section: Discussionmentioning

confidence: 99%

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Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration

Minamisawa,

Shirogane,

Watanabe

et al. 2024

JOR Spine

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BackgroundCondoliase is an enzyme used as a treatment for lumbar disc herniation (LDH). This enzyme degrades chondroitin sulfate (CS) in the nucleus pulposus of the intervertebral disc (IVD). However, there are cases in which symptoms do not improve, despite condoliase administration. This study reports histological analysis of lumbar disc tissue of LDH patients who underwent surgery because condoliase had no therapeutic effect.MethodsBetween March 2019 and August 2019, 12 LDH patients who underwent full endoscopic spine surgery (FESS) discectomy at the Dezawa Akira PED Clinic were the subjects of the study. There are two study groups: six cases underwent FESS after condoliase administration, while six underwent FESS without condoliase administration. The average duration from drug administration to surgery was 152 days. Herniated disc removed at surgery was evaluated by histological staining including immunohistochemistry by anti‐CS antibodies.ResultsMultiple large clusters (40–120 μm in diameter) were observed in the nucleus pulposus of those who received condoliase, but no clusters were observed in those who did not. The lumbar disc tissues, including the nucleus pulposus of recipients, were stained with anti‐CS antibodies that recognize the CS unsaturated disaccharide, but non‐administration tissue was not stained. These findings suggest that the enzyme acted on the nucleus pulposus, even in cases where symptoms were not improved by condoliase administration. Furthermore, there was no histological difference between stained images of the extracellular matrix in those who did or did not receive condoliase, suggesting that condoliase acted specifically on CS in the nucleus pulposus.ConclusionsWe demonstrated that CS in the nucleus pulposus was degraded in patients in whom condoliase did not have a therapeutic effect. Moreover, condoliase acts in human IVD without causing necrosis of chondrocytes and surrounding tissues.

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“…Moreover, patients with disc height recovery had a higher incidence of recovery based on Pfirrmann grading, compared to those without disc height recovery. 19 …”

Section: Discussionmentioning

confidence: 99%

“…Banno et al reported that 12.5% of the patients who administered condoliase for LDH subsequently required surgical treatment within 1 year. 19 However, the reason why condoliase showed no therapeutic effect on these LDH patients has not been elucidated.…”

Section: Introductionmentioning

confidence: 99%

Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration

Minamisawa,

Shirogane,

Watanabe

et al. 2024

JOR Spine

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“…Previous studies were retrieved from three major academic databases (PubMed, Scopus, and Web of Science) using the appropriate search term combinations, including “condoliase” OR “chondroitinase ABC” OR “chondroitin sulfate ABC endolyase” AND “lumbar disc herniation.” Basic research and review articles were excluded. Ultimately, 19 articles were selected, including three randomized controlled trials [ 9 , 10 , 17 ], 14 case series [ 12 , 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], and two case reports [ 11 , 30 ] ( Figure 2 ). Patient demographics were examined, including age, sex, LDH level, Pfirrmann grade, efficacy rate, and post-treatment surgical rate in patients with LDH treated with 1.25 units of condoliase.…”

Section: Methodsmentioning

confidence: 99%

Intradiscal Condoliase Injection Therapy for Recurrent Lumbar Disc Herniation: Case Series and Literature Review

Fukui,

Kamei,

Fujiwara

et al. 2023

Medicina

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Background and objectives: Although chemonucleolysis with condoliase for lumbar disc herniation (LDH) has become common, few reports have described its application in the treatment of recurrent LDH. Therefore, this study aimed to evaluate the safety and efficacy of condoliase treatment in six patients with recurrent LDH and review the available literature on condoliase treatment for LDH. Materials and Methods: Six patients (four men and two women; mean age, 64.7 years) with recurrent LDH who were treated with condoliase at our hospital between 2019 and 2022 were included. The clinical records and images of the patients were retrospectively evaluated. In addition, the available English literature on condoliase treatment for LDH was retrieved and reviewed. Results: Among the six patients included in the study, three showed >50% improvement in leg pain after treatment, which is a lower efficacy rate than that in previous reports. In addition, two patients required surgery after treatment, which is a higher rate than that in previous reports. The mean intervertebral disc height significantly decreased from 8.4 mm before treatment to 6.9 mm after treatment, consistent with the results of previous studies. None of the cases showed Modic type I changes on magnetic resonance imaging. Conclusions: Although the efficacy of condoliase treatment for recurrent LDH may be lower than that for primary LDH, this treatment was found to be safe and applicable for recurrent LDH.

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“…This study from Hamamatsu (Japan) showed that intervertebral discs may be repaired to some extent after chemonucleolysis treatment, even in young patients. 3 In their series of 60 patients, all with lumbar disc herniation treated with condoliase, serial MRI scans were used to evaluate the disc condition and changes in the visual analogue scale (VAS) pain scale and Oswestry Disability Index (ODI) were assessed at baseline, one-month, three-month, and one-year follow-up. Surgical treatment was required in 12.5% of patients (n = 8); however, in the remainder, ODI and VAS scores significantly improved at one year.…”

Section: Disc Degeneration Could Be Recovered After Chemonucleolysismentioning

confidence: 99%

Spine

2022

Bone & Joint 360

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The December 2022 Spine Roundup360 looks at: Deep venous thrombosis prophylaxis protocol on a Level 1 trauma centre patient database; Non-specific spondylodiscitis: a new perspective for surgical treatment; Disc degeneration could be recovered after chemonucleolysis; Three-level anterior cervical discectomy and fusion versus corpectomy- anterior cervical discectomy and fusion “hybrid” procedures: how does the alignment look?; Rivaroxaban or enoxaparin for venous thromboembolism prophylaxis; Surgical site infection: when do we have to remove the implants?; Determination of a neurologic safe zone for bicortical S1 pedicle placement; Do you need to operate on unstable spine fractures in the elderly: outcomes and mortality; Degeneration to deformity: when does the patient need both?

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Disc degeneration could be recovered after chemonucleolysis with condoliase.-1 year clinical outcome of condoliase therapy-

Cited by 18 publications

References 25 publications

Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration

Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration

Intradiscal Condoliase Injection Therapy for Recurrent Lumbar Disc Herniation: Case Series and Literature Review

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