Clinical efficacy and safety of intradiscal injection with collagenase and oxgen-ozone gas mixture to treat lumbar disc herniation in patients with grade I degenerative spondylolisthesis

Abstract

Objective To analyze the clinical efficacy and safety of collagenase and oxygen-ozone intradiscal injection for the treatment of lumbar disc herniation in patients with Grade I degenerative spondylolisthesis. Methods Forty-nine patients who suffered lumbar disc herniation with grade I spondylolysis were therapeutically cured by the intervertebral disc injection of eollagenase and oxygen-ozone under the guidance of CT. Clinical effects were evaluated by observing the changes of visual analogues scales （ VAS ）, the condition of taking painkillers and the distance of the sliding vertebrae and by using modified Macnab method on postoperative day and at final follow-up （6 months after surgery）. Results Compared with preoperative clinical data, the VAS score and score of taking painkillers both dropped sharply, which reflected a significant difference compared to the previous data by statistical method （P〈0.05）. At the same time, the distance of the sliding vertebrae had no significant transform during the whole observation period. 7 days and 6 months after surgery, the efficience rate of treatment that we evaluated by using modified Macnab was 85.71% and 87.76% respectively. There were no statistical significance between the two time point （P〉0.05）. However there was significant difference to compare the excellence rate between the two time point as it was 65.31% and 71.42% respectively （P〈0.05）. There were no serious postoperative complications or side effects in all the patients. Conclusions It is very effective clinically to get intradiscal injection of combined collagenase and oxygen-ozone guided by CT for the treatment of lumbar disc herniation in patients with Grade I degenerative spondylolisthesis as radicular symptoms were remarkably improved in most patients immediately after surgery. Meanwhile it can relieve painfulness of the patient and has no influence of sliding vertebrae, which means it is a safe, effective and minimally invasive method for treatment of lumbar disc herniation in patients with Grade I degenerative spondylolisthesis. Key words: Lumbar disc herniation; Spondylolysis; Collagenase; Oxyen-ozone; CT-guided