title: CT-guided chemonucleolysis combined with psoas compartment block in lumbar disc herniation: a randomized controlled study.
abstract: OBJECTIVE
  The study was designed to evaluate the effectiveness of the combination of chemonucleolysis and psoas compartment block (PCB) for the treatment of lumbar disc herniations (LDHs) and to explore the role of PCB in managing postoperative pain of collagenase injection.
  
  
  METHODS
  Two groups of patients (N = 192) were treated in different ways, respectively. Group A (N = 95) was treated with chemonucleolysis only (the injection of oxygen-ozone combined with collagenase into the lumbar disc and the epidural space); group B (N = 97) was treated with chemonucleolysis and PCB. After the treatment, the patients were followed-up, and the therapeutic effect was assessed at 1 week, 1 month, 3 months, and 6 months by the relative pain reduction, visual analog scale (VAS) pain scores, and the Oswestry Disability Index (ODI) scores.
  
  
  RESULTS
  In group A, treatment success rate was 64.2% (61 of 95), 82.1% (78 of 95), 84.2% (80 of 95), and 86.3% (82 of 95) at 1 week, 1 month, 3 months, and 6 months, respectively. In group B, treatment success rate was 86.5% (84 of 97), 89.6% (87 of 97), 93.8% (91 of 97), and 91.7% (89 of 97) at 1 week, 1 month, 3 months, and 6 months, respectively. There was statistically significant difference in outcome between two groups at 1 week, but there were no statistically significant difference in outcome between two groups at 1 month, 3 months, and 6 months. VAS scores and ODI were significantly decreased in both group A and group B, when compared with the baseline values in the same group at all points of follow-up. Group B produced a significant reduction in the VAS scores and ODI when compared with group A at: 1-week, 1-month, 3-month, 6-month follow-up.
  
  
  CONCLUSIONS
  Computer tomography (CT)-guided chemonucleolysis combined with PCB leads to rapid pain relief, fewer postoperative pain of collagenase injection happen, and should be regarded as a useful treatment for the management of LDH.
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Xiao X
authors.initials: XX
authors.lastname: Xu
authors.forename: Yong
authors.initials: Y
authors.lastname: Du
authors.forename: Han F
authors.initials: HF
authors.lastname: Yang
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Ya Y
authors.initials: YY
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: Meng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001623:Betamethasone / Q000627:therapeutic use; D017364:Collagenases / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008012:Lidocaine / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010100:Oxygen / Q000008:administration & dosage; D010147:Pain Measurement; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D014805:Vitamin B 12 / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D001623:Betamethasone; D008012:Lidocaine; D017364:Collagenases; D014805:Vitamin B 12; D010100:Oxygen
keywords: Chemonucleolysis; Lumbar Disc Herniation; Psoas Compartment Block