The Longitudinal Effectiveness Analysis Of Cervical Intervertebral Disc Herniation Syndrome With Posterior Approach Para-vertebral Microinvasive Chemonucleolysis By Collansese

Objective Cervical intervertebral disc herniation syndrome(radiculopathy type) is a common disease in pain department. For this syndrome, there are many thrapies.Among these thrapies, the microinvasive intervention may be the future mainstream trend on behalf of it's microinvision,fine clinical effect and lesser complications. The collagenase could resolve the degenerative intervertebral disc tissue specificly. Collagenase chemonucleolysis is one of the most efective methods for the treatment of lumbar disc herniation(LDH).Presently,the posterior approach cervical para-vertebral chemonucleolysis intervention by collansese for the disease is applied extensively. But the technique still lack of the large-scale cases retrospective analysis and the support of evidenced-based medicine.By the analysis of fellow-up results in 412 patients, the aim was to evaluate the longitudinal effectiveness and the influence factors of the microinvasive intervention.Methods Ingroup patients were chose strictly according to the ingroup criteria and exclusion criteria. The clinical characteristics data in patients(the medical history, the imaging manifestations, the CT value of projection, the herniated disc numbers) were obtained before intervention. Through regular post-intervention fellow-up, the VAS scores in different timings(preoperation, post-lstday,2nday,3rdday,7thday, 2ndweek,4thweek,6thweek,0.5thyear,1 styear,2ndyear) and the Mac Nab questionnaire scores in fellow-up end-point were obtained.Through statistical analysis, the excellence rates and the marked effect rates were presented.Moreover, we evaluated the influence factors for the Mac Nab questionnaire scores in end-point, such as the CT value of projection.Results In this fellow-up research, the excellence rates and the marked effect rates were 150/412,36% and 368/412,89%,respectively. The single factor correlation analysis showed: the medical history (x2=9.547, P=0.034), the CT value of projection (x2=27.638, P=0.001) the imaging manifestations (x2=22.636, P=0.012) and the herniated disc numbers(x2=42.534, P=0.025) correlate to the Mac Nab questionnaire scores in end-point, but the genter ratios not(x2=10.658, P =0.0540). The binary logistic regression analysis showed: the CT value of projection (OR 6.128,95%CI 2.168-17.321) and the imaging manifestations (OR 0.062,95%CI 0.007-0.544) were independent influence factors for the Mac Nab questionnaire scores in end-point.Conclusion1,The posterior approach cervical para-vertebral chemonucleolysis intervention by collansese is an effective therapy.2,The CT value of projection and the imaging manifestations were two independent influence factors for the intervention effect.3,CT number of the hernial intervertebral disc can be one of the objective indexes for prognosis of collagenase chemonucleolysis for cervical intervertebral disc herniation syndrome(radiculopathy type).