Evidence map›Paper›PMID 41402394›Full record

ArticleScientific reports2025

Cost-effectiveness of intradiscal injection with condoliase versus microendoscopic discectomy for lumbar disc herniation: a retrospective multicenter study.

Takuya Takahashi, Hiroyuki Sato, Yohei Takahashi, Kota Watanabe, Tomohiro Banno, Kyohei Sakaki, Yoshiyasu Arai, Yuichi Takano, Yawara Eguchi, Yuki Taniguchi and 12 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Takuya TakahashiDepartment of Orthopedics, Graduate School, Institute of Science Tokyo, 1-5-45 Yushima , Bunkyo-ku, Tokyo, 113-8510, Japan.
Hiroyuki SatoDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Bunkyo-ku, Tokyo, Japan.
Yohei TakahashiDepartment of Orthopedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan.
Kota WatanabeDepartment of Orthopedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan.
Tomohiro BannoDepartment of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-shi, Shizuoka, Japan.
Kyohei SakakiDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi-shi, Saitama, Japan.
Yoshiyasu AraiDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi-shi, Saitama, Japan.
Yuichi TakanoDepartment of Orthopedic Surgery, Inanami Spine and Joint Hospital, Shinagawa-ku, Tokyo, Japan.
Yawara EguchiDepartment of Orthopedic Surgery, Shimoshizu National Hospital, Yotsukaido-shi, Chiba, Japan.
Yuki TaniguchiDepartment of Orthopedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Satoshi MakiDepartment of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba-shi, Chiba, Japan.
Yasuchika AokiDepartment of Orthopedic Surgery, Eastern Chiba Medical Center, Togane-shi, Chiba, Japan.
Toshitaka YoshiiDepartment of Orthopedics, Graduate School, Institute of Science Tokyo, 1-5-45 Yushima , Bunkyo-ku, Tokyo, 113-8510, Japan.
Hiroshi YamadaDepartment of Orthopedic Surgery, Wakayama Medical University, Wakayama-shi, Wakayama, Japan.
Takashi KaitoDepartment of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Yutaka HiraizumiDepartment of Orthopedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
Masatune YamagataDepartment of Orthopedic Surgery, Oyuminochuobyoin Mobara Clinic, Mobara-shi, Chiba, Japan.
Masaya NakamuraDepartment of Orthopedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan.
Naobumi HosoganeDepartment of Orthopedic Surgery, Kyorin University School of Medicine, Mitaka-shi, Tokyo, Japan.
Akihiro HirakawaDepartment of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Bunkyo-ku, Tokyo, Japan.
Seiji OhtoriDepartment of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba-shi, Chiba, Japan.
Takashi HiraiDepartment of Orthopedics, Graduate School, Institute of Science Tokyo, 1-5-45 Yushima , Bunkyo-ku, Tokyo, 113-8510, Japan. hirai.orth@tmd.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Intradiscal condoliase injection has been described as a safe treatment with relatively favorable results. In Japan, the direct medical cost of intradiscal condoliase injection is significantly lower than that of microendoscopic discectomy (MED). The objective of this study was to assess the cost-effectiveness of condoliase injection compared to MED in patients with lumbar disc herniation (LDH). This retrospective study included patients who received either an intradiscal condoliase injection or MED for LDH at nine participating centers. Pretreatment magnetic resonance imaging revealed that the patients had subligamentous-type herniation. A Markov model was used to evaluate cost-effectiveness. The robustness of the results was assessed using one-way and probabilistic sensitivity analyses. The cost-effectiveness was assessed using data from 229 patients treated with condoliase injection and 98 patients treated with MED. Condoliase injection had a significantly lower mean direct cost compared to MED, while the quality-adjusted life years were equal, indicating similar effectiveness and potential for cost savings. A one-way sensitivity analysis revealed that condoliase injection remained superior in nearly all scenarios. A probabilistic sensitivity analysis revealed that condoliase injection was cost-saving compared to MED in 92.6% of cases. These findings indicate that intradiscal condoliase injection is cost-saving compared to MED for the treatment of LDH.

Indexed as

DiskectomyEndoscopyIntervertebral Disc DisplacementLumbar VertebraeAdultAgedCost-Benefit AnalysisFemaleHumansJapanMagnetic Resonance ImagingMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsRetrospective StudiesCondoliaseCost-effectivenessLumbar disc herniationMicroendoscopic discectomy

Identifiers

PMID41402394
PMCPMC12708873

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.