Collagenase Chemonucleolysis vs Percutaneous Endoscopic Lumbar Discectomy (PELD) for Lumbar Disc Herniation

Collagenase Chemonucleolysis vs Percutaneous Endoscopic Lumbar Discectomy (PELD) for Lumbar Disc Herniation, a Randomized Controlled Trial

Lumbar disc herniation compressed the nerve cause pain, numbness, weak legs called sciatica, which seriously decrease the quality of life and work efficiency. Both collagenase chemonucleolysis(CCNL) and percutaneous endoscopic lumbar discectomy (PELD) was effective to treat lumbar disc herniation(LDH) requires surgery. whether functional clinical outcomes of CCNL vs PELD effect on LDH was superior, and no study provided convincing evidence.

Lumbar disc herniation (LDH) is a common disease with an incidence of 1%-3%, usually manifested as low back pain radiating to the lower extremities, which seriously affects patients' quality of life. Collagen hydrolysis was effective in treating LDH, it makes the protrusion smaller or disappeared, relieving or resolving the compression of nerve root by the protrusion.Percutaneous endoscopic lumbar discectomy (PELD) is a less invasive techniques to treat LDH. However, the outcomes of collagen hydrolysis vs PELD effect was still unknown.

Inclusion Criteria:

• at least six weeks of excessive radiating leg pain with no tendency for any clinical improvement despite conservative therapy
• have a nerve root compression by a lumbar disc herniation proven by magnetic resonance imaging

Exclusion Criteria:

• previous surgery at the same or adjacent disc level;
• isthmic or degenerative spondylolisthesis
• pregnancy
• severe comorbid medical or psychiatric disorder (American Society of Anesthesiologists' classification >2);
• severe caudal or cranial sequestration of disc fragments, defined as sequestration towards more than half of the adjacent vertebra;
• contraindication for surgery