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目的：对颈椎间盘内注射胶原酶的疗效进行评估；将治疗前后的椎间盘影像学变化同临床症状的改变相联系，以期阐明作用机制。方法：１９９７年６月～１９９８年６月使用国产胶原酶冻干制品，结合经皮切吸术治疗颈椎间盘突出症８例。胶原酶注射局部麻醉和影像增强监视下进行。１２００Ｕ的胶原酶溶于５ｍｌ无菌水中，取一半剂量注入每个突出的间盘，注射时间平均为１５ｍｉｎ。８例患者的１２个间盘在注射前后均作双盲法的影像学评价，患者在术后留院观察３天。结果：术后６～１２个月的随访观察表明，８例患者中７例（占８７％）的疼痛明显减轻或消失，无严重并发症发生，临床效果满意。１例有２个椎间盘突出的患者疼痛无减轻，疗效一般。突出物平均回缩１０％（与椎管前后径相比较），间盘信号均减低。５例患者的椎间盘突出持续存在。术后椎间盘突出存在与否和临床疗效无明显关联。结论：此研究结果表明，胶原酶溶核术是一种行之有效的治疗方法，其完善的治疗常规亟待建立。
OBJECTIVE: To evaluate the efficacy of collagenase injection into cervical intervertebral disc, and to correlate the changes of intervertebral disc imaging before and after treatment with changes of clinical symptoms in order to elucidate the mechanism of action. Methods: June 1997 ~ June 1998 using domestic collagenase freeze-dried products, combined with percutaneous incision suction treatment of cervical disc herniation in 8 cases. Collagenase injection is performed under local anesthesia and image enhancement monitoring. 1200U of collagenase dissolved in 5ml sterile water, take half the dose into each prominent disc, injection time average of 15min. The 12 intervertebral discs of 8 patients were evaluated by double-blind imaging before and after the injection. The patients were observed for 3 days postoperatively. Results: The follow-up of 6 to 12 months postoperatively showed that the pain in 7 patients (87%) of 8 patients significantly reduced or disappeared without serious complications and the clinical effect was satisfactory. One patient with 2 herniated discs had no pain relief and had a similar overall response. The average retraction of 10% (compared with the anteroposterior diameter of the canal), disc signal decreased. Disc herniation persisted in 5 patients. There was no significant correlation between the presence of postoperative disc herniation and clinical efficacy. Conclusion: The results of this study show that collagenase nucleolytic therapy is an effective treatment method, and its perfect treatment routine needs to be established urgently.