胶原酶化学溶解术治疗腰椎间盘突出症的研究进展

摘要

The clinical application of collagenase chemonucleolysis in the treatment of lumbar intervertebral disc herniation has been lasted for more than 40 years. Many studies have shown that the collagenase which is injected into the intervertebral disc can hydrolyze the collagen into amino acids which are ifnally absorbed by the human body. However, the speciifc process for its hydrolysis remains to be further studied. In recent years, clinical research has proved that the site and dose for the injection of collagenase are highly correlated with its safety and efifcacy. A long-term and good result can be obtained by injection of low-dose collagenase into the protrusion or combination of intradiscal and epidural injection. The normal hydrolysis of intervertebral disc can be reduced by injection of low-dose collagenase into the disc interior combined with radiofrequency and the overall effect can be improved, which has been conifrmed in the treatment of intervertebral disc herniation. Collagenase chemonucleolysis is a minimally invasive treatment method with high safety and effectiveness.%胶原酶化学溶解术治疗腰椎间盘突出症在临床应用已40余年。研究表明胶原酶注入病变椎间盘后水解胶原分子为相关氨基酸，最终被机体吸收，但其水解的具体过程仍待进一步研究。近年临床研究证明：注射部位和剂量与安全效果高度相关；小剂量胶原酶突出物注射或盘内外联合注射可获较好远期效果；小剂量胶原酶注射联合射频可减少正常椎间盘水解，提高整体效果，并已在椎间盘突出症治疗中证实。胶原酶化学溶解术仍是临床经典、安全及有效的微创治疗方法。