Effects of catheter-based extradural collagenase chemonucleolysis on pain scores and lumbar function in patients with lumbar disc herniation

Aim: Lumbar disc herniation (LDH) is a leading cause of radicular pain and disability. While conventional intradiscal collagenase chemonucleolysis (ICCN) is a minimally invasive alternative to surgery, it is limited by suboptimal drug targeting and recurrence. Catheter-based extradural collagenase chemonucleolysis (CECCN) was developed to deliver the enzyme directly to the herniated fragment. This research aimed to compare the clinical efficacy and safety of CECCN versus ICCN. Methods: = 150) was established through retrospective review of medical records of patients who underwent conventional ICCN at the Department of Pain, The Second Affiliated Hospital of Guizhou Medical University between January 2023 and December 2024, met the same inclusion and exclusion criteria, and completed the predefined outcome assessments at the required follow-up time points. The outcomes were operation time, hospital stay, pain severity, lumbar function, clinical efficacy, quality of life and complications. Results: < 0.05). Conclusion: CECCN is more effective than conventional ICCN for relieving pain, improving function and quality of life, and reducing complications in LDH patients. The superior outcomes support its role as an advanced percutaneous treatment option, despite a longer procedural time.