Verification of selection trends in interventional treatment for patients with lumbar disc herniation and effects of condoliase therapy.

Abstract This study aims to investigate selection trends in treatment for lumbar disc herniation (LDH) and the effects of condoliase therapy on muscle weakness. Patients with leg pain caused by LDH who received interventional treatment between September 2017 and August 2022 were included in this study. LDH patients were divided into two groups: an operative treatment group and condoliase therapy group. The period between September 2017 and August 2022 was divided into 5 equal parts and changes in the percentage of intervention treatment were examined. Sex, age, the body mass index (BMI), duration of symptoms, herniation level, and neurological findings were examined in the two groups. Motor recovery was also assessed in the two groups. Subjects included 226 males and 115 females with a mean age of 49.2 years, mean BMI of 22.8, and mean duration of symptoms of 5.0 months. The ratio between operative treatment and condoliase therapy reversed in the third year after the introduction of condoliase therapy. In the fourth year, condoliase therapy became the main treatment for LDH. Lower limb muscle strength improved in 76% of cases receiving condoliase therapy. Condoliase therapy has become an intermediate treatment before surgery in our institutions. Motor recovery in patients receiving condoliase therapy was not inferior to that after surgery; however, in cases with severe muscle weakness with manual muscle testing ≤3, the improvement rate was approximately 60%. These results will be useful for clinicians when providing informed consent and selecting condoliase therapy.