ArticleBMC surgery2026
Efficacy and safety of low-temperature plasma ablation combined with collagenase in the treatment of lumbar disc herniation.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
backgroundLumbar disc herniation (LDH) is a common cause of radicular pain and disability. Evidence regarding the incremental effectiveness of combining plasma-based intradiscal decompression with collagenase chemonucleolysis remains limited.
methodsThis single-center retrospective cohort study included consecutive hospitalized adults with imaging-confirmed LDH treated between July 2021 and July 2025. Patients underwent low-temperature plasma ablation alone (control group, n = 108) or plasma ablation plus intradiscal collagenase (observation group, n = 116). The primary outcomes were longitudinal Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores assessed at baseline, 1 week, 1 month, 3 months, and 6 months. Linear mixed-effects models evaluated treatment group, time, and group × time interactions after adjustment for clinical and imaging covariates. Secondary outcomes included clinically meaningful improvement, symptomatic imaging-confirmed recurrence, reintervention, perioperative characteristics, and complications. Propensity score matching and sensitivity analyses were performed.
resultsVAS and ODI scores decreased over time in both groups (both time effects, P < 0.001), with significant group × time interactions for VAS (P = 0.002) and ODI (P = 0.006). At 6 months, the adjusted mean differences favored the observation group for VAS (- 0.54; 95% CI, - 0.81 to - 0.27) and ODI (- 5.10% points; 95% CI, - 7.47 to - 2.73). Six-month VAS responder rates were 91.2% and 96.3% (RR, 1.06; 95% CI, 0.98-1.13), while ODI responder rates were 83.2% and 91.6% (RR, 1.10; 95% CI, 0.99-1.22), respectively. Recurrence and reintervention were numerically less frequent in the observation group, but confidence intervals were wide and crossed 1. Overall complications occurred in 11.1% and 7.8% of patients, respectively (RR, 0.70; 95% CI, 0.31-1.59).
conclusionsPlasma ablation combined with intradiscal collagenase was associated with modestly lower VAS and ODI scores over 6 months than plasma ablation alone. Differences in clinically meaningful response rates were not statistically significant, and low event numbers precluded firm conclusions regarding recurrence, reintervention, or comparative safety.
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