CT ‐Guided Chemonucleolysis Combined with Psoas Compartment Block in Lumbar Disc Herniation: A Randomized Controlled Study

Objectives 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 ( LDH s) 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 O swestry D isability 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 .