The effectiveness of chemonucleolysis with condoliase for lumbar disc herniation in elderly patients over 70 years old

Chemonucleolysis with condoliase is a novel minimally invasive treatment for lumbar disc herniation (LDH). However, the effectiveness in elderly population have not been established yet. Our study seeks to investigate the outcomes of condoliase treatment in patients over 70 years old by comparing with those under 70 years old. In a retrospective study, eligible patients with LDH who underwent intradiscal condoliase injection from July 2019 to December 2024 were divided into two groups: an elderly group aged ≥ 70 years and a younger group aged < 70 years. Baseline characteristics, clinical outcomes using visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores, radiological findings, and adverse events were compared between the two groups. Of 172 patients, 36 (20.9%) were aged ≥ 70 years and 136 (79.1%) were aged < 70 years. At the 3-month follow-up, both the elderly and younger groups showed significant improvements in JOA scores (mean change: 4.2 vs. 5.5) and each VAS of symptoms (mean change: − 2.2 vs. − 2.1 for back pain, − 3.2 vs. − 3.7 for leg pain, − 2.4 vs. − 3.3 for leg numbness) with no significant differences between the groups. Similar improvements were observed at the 6 and 12 months. Remarkably, the elderly group showed a lower rate of additional surgical interventions after condoliase treatment. Condoliase treatment showed similarly favorable clinical outcomes in elderly patients aged ≥ 70 years compared with younger patients. Chemonucleolysis with condoliase may be a minimally invasive treatment option for elderly patients with LDH.