Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation
Introduction: Condoliase-based chemonucleolysis is a minimally invasive intermediate treatment option between conservative approaches and surgical interventions for lumbar disk herniation (LDH). In this study, the effects of psychological factors on the clinical outcomes of condoliase therapy for LD...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2024-03-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0117/_pdf/-char/en |
| _version_ | 1797215537287135232 |
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| author | Tomohiro Banno Tomohiko Hasegawa Yu Yamato Go Yoshida Hideyuki Arima Shin Oe Koichiro Ide Tomohiro Yamada Kenta Kurosu Yukihiro Matsuyama |
| author_facet | Tomohiro Banno Tomohiko Hasegawa Yu Yamato Go Yoshida Hideyuki Arima Shin Oe Koichiro Ide Tomohiro Yamada Kenta Kurosu Yukihiro Matsuyama |
| author_sort | Tomohiro Banno |
| collection | DOAJ |
| description | Introduction: Condoliase-based chemonucleolysis is a minimally invasive intermediate treatment option between conservative approaches and surgical interventions for lumbar disk herniation (LDH). In this study, the effects of psychological factors on the clinical outcomes of condoliase therapy for LDH were assessed.
Methods: This study involved patients with LDH who received condoliase injections over a 1-year follow-up period. Data from the visual analog scale (VAS) scores for leg and back pain, Oswestry Disability Index, and Hospital Anxiety and Depression Scale (HADS), which was utilized for the psychological assessment, were collected. Using magnetic resonance imaging, changes in disk height and degeneration were evaluated. Data were assessed at baseline and 1-month, 3-month, and 1-year follow-ups. Condoliase therapy was considered effective in patients whose VAS score for leg pain improved by 50% at 1 year from baseline and who did not require surgery. The patients were divided into two groups: those who reported effective treatment (Group E) and those who did not (Group I). Between these two groups, comparative analyses were carried out.
Results: In this study, a total of 102 patients (70 men; mean age, 43.8±18.2 years) were included. Condoliase therapy was effective in 76 patients (74.5%). Thirty-five patients (34.3%) showed psychological factors (HADS-Anxiety [HADS-A]8 or HADS-Depression [HADS-D]8) preoperatively and had a significantly lower rate of effectiveness than did those without psychological factors. Group I demonstrated significantly higher baseline back pain VAS, HADS, and HADS-D scores when compared with Group E. Logistic regression analysis identified females and the baseline HADS-D score as independent factors that were related to the effectiveness of condoliase therapy.
Conclusions: The patients with psychological factors tended to experience residual pain resulting in adverse effects on the clinical outcomes of chemonucleolysis with condoliase. |
| first_indexed | 2024-04-24T11:31:38Z |
| format | Article |
| id | doaj.art-0aedd66e490a41e79ab5e675702ebdd2 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-24T11:31:38Z |
| publishDate | 2024-03-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-0aedd66e490a41e79ab5e675702ebdd22024-04-10T08:13:49ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2024-03-018219520210.22603/ssrr.2023-01172023-0117Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk HerniationTomohiro Banno0Tomohiko Hasegawa1Yu Yamato2Go Yoshida3Hideyuki Arima4Shin Oe5Koichiro Ide6Tomohiro Yamada7Kenta Kurosu8Yukihiro Matsuyama9Department of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineIntroduction: Condoliase-based chemonucleolysis is a minimally invasive intermediate treatment option between conservative approaches and surgical interventions for lumbar disk herniation (LDH). In this study, the effects of psychological factors on the clinical outcomes of condoliase therapy for LDH were assessed. Methods: This study involved patients with LDH who received condoliase injections over a 1-year follow-up period. Data from the visual analog scale (VAS) scores for leg and back pain, Oswestry Disability Index, and Hospital Anxiety and Depression Scale (HADS), which was utilized for the psychological assessment, were collected. Using magnetic resonance imaging, changes in disk height and degeneration were evaluated. Data were assessed at baseline and 1-month, 3-month, and 1-year follow-ups. Condoliase therapy was considered effective in patients whose VAS score for leg pain improved by 50% at 1 year from baseline and who did not require surgery. The patients were divided into two groups: those who reported effective treatment (Group E) and those who did not (Group I). Between these two groups, comparative analyses were carried out. Results: In this study, a total of 102 patients (70 men; mean age, 43.8±18.2 years) were included. Condoliase therapy was effective in 76 patients (74.5%). Thirty-five patients (34.3%) showed psychological factors (HADS-Anxiety [HADS-A]8 or HADS-Depression [HADS-D]8) preoperatively and had a significantly lower rate of effectiveness than did those without psychological factors. Group I demonstrated significantly higher baseline back pain VAS, HADS, and HADS-D scores when compared with Group E. Logistic regression analysis identified females and the baseline HADS-D score as independent factors that were related to the effectiveness of condoliase therapy. Conclusions: The patients with psychological factors tended to experience residual pain resulting in adverse effects on the clinical outcomes of chemonucleolysis with condoliase.https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0117/_pdf/-char/enchemonucleolysiscondoliase therapylumbar disk herniationpsychological factors |
| spellingShingle | Tomohiro Banno Tomohiko Hasegawa Yu Yamato Go Yoshida Hideyuki Arima Shin Oe Koichiro Ide Tomohiro Yamada Kenta Kurosu Yukihiro Matsuyama Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation Spine Surgery and Related Research chemonucleolysis condoliase therapy lumbar disk herniation psychological factors |
| title | Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation |
| title_full | Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation |
| title_fullStr | Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation |
| title_full_unstemmed | Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation |
| title_short | Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation |
| title_sort | psychological factors can affect the clinical outcome of chemonucleolysis with condoliase in patients with lumbar disk herniation |
| topic | chemonucleolysis condoliase therapy lumbar disk herniation psychological factors |
| url | https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0117/_pdf/-char/en |
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