Effect Of Coblation Combined With Collagenase On Intervertebral Space Height In The Treatment Of Lumbar Disc Herniation

Objective To compare and analyze whether coblation nucleoplasty and extra-disc collagenase chemonucleolysis can affect lumbar intervertebral space height in the treatment of lumbar disc herniation,and whether these changes in lumbar intervertebral space height can cause corresponding changes in clinical symptoms.Methods Sixty-nine patients with lumbar disc herniation who were hospitalized in our department from March 2018 to August 2020 and underwent imaging follow-up after discharge were selected.The clinical data of 35 patients with lumbar disc herniation treated with simple coblation nucleoplasty and 34 patients with lumbar disc herniation treated with coblation nucleoplasty combined with extra-disc collagenase chemonucleolysis were retrospectively analyzed.The height changes of the lesion lumbar intervertebral space between the two groups preoperative and postoperative 3 to 5 months were compared,and the changes of low back pain and leg pain in both groups were also being compared.The height changes of lumbar intervertebral space were measured and compared by the hospital’s Picture Archiving and Communication Systems（PACS）,and the data of changes of low back pain and leg pain before and after operation were obtained by outpatient follow-up or telephone follow-up.Results Compared with preoperative results,the heights of the anterior and posterior margin and the midpoint of the lumbar intervertebral space in both groups were decreased at 3 to 5 months after operation,and the difference was statistically significant（P<0.01）.In comparison between the two groups,the height reduction of the anterior,posterior and midpoint of the intervertebral space in the simple coblation nucleoplasty treatment group was smaller than that in the coblation nucleoplasty combined with extra-disc collagenase chemonucleolysis treatment group,and there was a statistical difference（P<0.01）.In comparison between the two groups,the therapeutic effect of the coblation nucleoplasty combined with extra-disc collagenase chemonucleolysis treatment group was better than the simple coblation nucleoplasty treatment group,and the difference was statistically significant（P<0.05）.Conclusion Coblation nucleoplasty alone and coblation nucleoplasty combined with extra-disc collagenase chemonucleolysis can cause postoperative lumbar intervertebral space height drop.However,the coblation nucleoplasty combined with extra-disc collagenase chemonucleolysis resulted in a great decrease of lumbar intervertebral space height.In addition,an appropriate reduction in lumbar space height may lead to improvement of clinical symptoms.