Islamic International Medical College, Rawalpindi, Pakistan.
Neurosurg Rev. 2024 Sep 6;47(1):553. doi: 10.1007/s10143-024-02811-4.
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.
本研究考察了康诺酶化学核切术（CC）治疗腰椎间盘突出症（LDH）的疗效和安全性，并强调了硫酸软骨素 ABC 内裂解酶等新兴替代方法。研究表明，康诺酶是一种用于降解髓核中糖胺聚糖的酶，可有效迅速缓解腿部疼痛，治疗后一天内即可观察到显著缓解。研究表明，较低的预处理直腿抬高（SLR）角度可能预示着早期症状缓解，康诺酶在高达 1.25U 的剂量下通常有效，在疗效和安全性之间取得平衡。尽管有令人鼓舞的结果，但人们对长期安全性仍存在担忧，包括椎间盘高度降低和影像学变化。此外，硫酸软骨素 ABC 内裂解酶作为一种更安全、更有效的替代方法具有潜力，但仍需要进一步研究来优化治疗方案并评估长期结果。未来的研究应解决当前的局限性，如样本量小和随访时间短，以更好地了解这些治疗方法的长期获益和风险。
