The Correlation Between CT Value And Surgery Effect Of Target- Injection Of Collagenase And O3 Chemonucleolysis By CT Guidance For The Treatment Of Lateral Lumbar Disc Herniation

Collagenase chemonucleolysis is one of the most efective methods for the treatment of lumbar disc herniation(LDH) .China,there are so many patients with LDH received the treatment of collagenase chemonucleolysis every year.Ozone is known as one of the most intense oxidants.For the last decade, ozone has been used in some western-European countries fortreatment of lumbar discal herniation,and good results were reported.From 2000, ozone also has been used in some native hospitals for treatment of lumbar discal herniation,and also good results were reported and were worth using widely.In recent years, it were found to combined injections of ozone and collagenase in the treatment of lumbar disc herniation and has achieved good results.But it has not an objective index to predict the curative efect of collagenase chemonucleolysis. We considered CT value of the hernial disc as an objective index for prognosis of collagenase chemonucleolysis.Objective: To investigate the correlation between CT value and surgery effect of target- injection of collagenase and O3 chemonucleolysis by CT guidance for the treatment of lateral lumbar disc herniation. Exploring the feasibility of CT value as an objective index for prognosis of target-injection of collagenase and O3 chemonucleolysis by CT guidance for the treatment of lateral lumbar disc herniation. Methods: 100 patients with LDH from June 2008 to June 2009 were analyzed retrospectively, 53males and 47 females.Their ages were between 18 and 65 years, the average was 54.2 years. The course of disease was between 1 month and 15 years.45 of the 100 patients were L4-5 intercalated disc henria, the other 55 patients were L5-S1 intercalated disc hernia.The 100 patients with LDH were divided into 2 groups according to the box-type plot of CT values and curative effect which were≤90, >90.The operation was carried out under CT guidance, and the target was the prominence. The puncture layer and the pathwaywere selected according to the CT image,then collagenase was injected by the percutaneous hernia-puncture with the multipurpose spondylous needles.Results: The successful rate of the first puncture was 100% on the100 times. There were negative correlation between the CT values of the hernial disc and curative effect. After 3 months follow-up, 100 cases of patients received interventional treatment of collagenase, the excellent and good rate was 67.0% and the total effective rate was 79.0%. CT value≤90 group: The excellent and good rate was85.0%, and the effective rate was95.0%. CT value >90 group: The excellent and good rate was 27.5%, and the effective rate was 50.0%. After 6 months follow-up, 100 cases of patients received interventional treatment of collagenase, the total excellent and good rate was 79.0% and the total effective rate was 91.7%. CT value≤90 group: The excellent and good rate was 67.0%, and the effective rate was96.7%. CT value >90 group: The excellent and good rate was 30.0%, and the effective rate was 52.5%.The difference of effective rate in the two groups was significant,the effective rate of group≤90 were higher than group> 90.There were no correlation between age,gender,body weight,case history,the position of hernial intervertebral disc and curative effect .Conclusion: In the target-injection of collagenase and O3 chemonucleolysis by CT guidance for the treatment of lateral lumbar disc herniation, the prominence CT value and the curative effect assume the obvious inverse correlation.The prominence CT value may take one choice method of treatment and the forecast surgery curative effect objective indicator.