Clinical Outcomes of Intradiscal Condoliase Injection for Lumbar Disc Herniation: A Retrospective Analysis of the First 100 Cases

Background Intradiscal injection of condoliase is a minimally invasive treatment positioned between conservative management and surgery for lumbar disc herniation (LDH). Objective To evaluate the short- to mid-term clinical course and radiological changes following condoliase treatment in routine clinical practice. Methods This retrospective observational study analyzed 100 consecutive patients with LDH who underwent intradiscal condoliase injection between December 2018 and July 2023. Clinical outcomes were evaluated using the visual analog scale (VAS). Radiological findings were assessed using established magnetic resonance imaging classifications. Clinical outcomes and subsequent treatments were analyzed. Results The median symptom duration was 20 weeks. Mean leg pain VAS significantly improved from 7.4 ± 2.1 at baseline to 3.7 ± 2.4 at one month and 2.4 ± 2.2 at three months (p < 0.05). Symptomatic improvement was observed in 87 patients (87.0%), with a median time to relief of four weeks. Five patients (5.0%) required subsequent surgery. No major complications were observed, including neurological deterioration, infection (discitis), anaphylaxis, hospitalization related to the procedure, or death. Conclusions Intradiscal condoliase injection was associated with a significant early reduction in leg pain in the majority of patients with LDH and may serve as an effective intermediate treatment between conservative management and surgery.