Intradiscal ozone therapy for lumbar disc herniation

Sibel Ozcan; Arzu Muz; Aysun Yildiz Altun; Selami Ates Onal

doi:10.14715/cmb/2018.64.5.8

Issue

Vol. 64 No. 5: Issue 5

Issue Published : May 1, 2018

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Intradiscal ozone therapy for lumbar disc herniation

https://doi.org/10.14715/cmb/2018.64.5.8

Sibel Ozcan

Department of Anesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig, Turkey

Arzu Muz

Section of Pain Management, Firat University School of Medicine, Elazig, Turkey

Aysun Yildiz Altun

Department of Anesthesiology and Reanimation, Firat University School of Medicine, Elazig, Turkey

Selami Ates Onal

Section of Pain Management, Firat University School of Medicine, Elazig, Turkey

Corresponding Author(s) : Sibel Ozcan

dr.sibelcozcan@gmail.com

Cellular and Molecular Biology, Vol. 64 No. 5: Issue 5
Article Published : April 30, 2018

Abstract

The rationale behind intradiscal O2-O3 therapy is the pain elicited by the mechanical compression of the nerve root, which is associated with periganglionic and periradicular inflammation. This study aimed to determine the effect of intradiscal ozone injection on pain score and satisfaction of patients with low back pain (LBP) secondary to disc herniation. Patients with LBP diagnosed with disc herniation were enrolled in this clinical trial. After prepping and draping the area, intradiscal injection of ozone/oxygen mixture (10 ml, 25Î¼g/ml) was performed under fluoroscopy guide (c-arm). Pain score and patient satisfaction were assessed prior to the injection (baseline) and 1, 3, 6, 12 and 24 months after the injection. Sixty three patients (24 males, 39 females) with mean age of 53.3 ±2.0 y enrolled in the study. The mean±standard deviation (SD) of pain score before intervention was 6.968 ±0.11. Pain score was reduced to 4.25±0.19 at 1 month, 4.33±0.20 at 3 months, 4.87 ±0.21 at 6 months and 5.22 ±0.20 at 24 months. According to the modified MacNab scale success of pain relief was as follows: excellent: 4 (6.3%), good: 17 (26.98 %), sufficient: 13 (20.63 %), poor: 13 (20.63 %), no result: 11 (17.46%), negative: 4 (6.3 %). Intradiscal ozone therapy was determined to provide improved outcomes in patients with single level of bulging and protrusion.

Keywords

Intradiscal ozone Lumbar disc herniation Pain score Patient satisfaction.

Ozcan, S., Muz, A., Yildiz Altun, A., & Onal, S. A. (2018). Intradiscal ozone therapy for lumbar disc herniation. Cellular and Molecular Biology, 64(5), 52–55. https://doi.org/10.14715/cmb/2018.64.5.8

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References

Long DM. Decision making in lumbar disc disease. Clin Neurosurg. 1992; 39: 36–51.
Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000;13(3):205–217.
Gangi A, Dietemann JL, Mortazavi R, Pfleger D, Kauff C, Roy C. CT-guided interventional procedures for pain management in the lumbosacral spine. Radiographics. 1998;18(3):621–633.
Gautam S, Rastogi V, Jain A, Singh AP. Comparative evaluation of oxygen-ozone therapy and combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation for the treatment of lumbar disc herniation. Pain Pract. 2011;11(2):160–166.
Iliakis E, Valadakis V, Vynios DH, Tsiganos CP, Agapitos E. Rationalization of the activity of medical ozone on the intervertebral disc. A Histological and Biochemical Study. Rivista di Neuroradiologia. 2001;14(1):23-30.
Bocci V. Ozone: A new medical drug. 2nd ed. Dordrecht: Springer; 2011: 210-243.
Bocci V, Borrelli E, Zanardi I, Travagli V. The usefulness of ozone treatment in spinal pain. Drug Des Devel Ther. 2015;9:2677-2685.
Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M. Minimally invasive oxygen-ozone therapy for lumbar disk herniation. AJNR Am J Neuroradiol. 2003;24(5):996–1000.
Bonetti M, Fontana A, Cotticelli B, Volta GD, Guindani M, Leonardi M. Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR Am J Neuroradiol. 2005;26(5):996–1000.
Al-Jaziri AA, Mahmoodi SM. Painkilling effect of ozone-oxygen injection on spine and joint osteoarthritis. Saudi Med J. 2008;29(4):553–557.
Vaillant JD, Fraga A, Diaz MT, Mallok A, Viebahn-Hänsler R, Fahmy Z, Barberá A, Delgado L, Menéndez S, Fernández OS. Ozone oxidative postconditioning ameliorates joint damage and decreases pro-inflammatory cytokine levels and oxidative stress in PG/PS-induced arthritis in rats. Eur J Pharmacol. 2013;714(1-3):318–324.
Muto M, Avella F. Percutaneous treatment of herniated lumbar disc by intradiscal oxygen-ozone injection. Interv Neuroradiol. 1998;4(4):279–286
Muto M, Andreula C, Leonardi M. Treatment of herniated lumbar disc by intradiscal and intraforaminal oxygen-ozone (O2-O3) injection. J Neuroradiol. 2004;31(3):183–189.
Gallucci M, Limbucci N, Zugaro L, Barile A, Stavroulis E, Ricci A, Galzio R, Masciocchi C. Sciatica: Treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only. Radiology. 2007;242(3):907–913.
Muto M, Ambrosanio G, Guarnieri G, Capobianco E, Piccolo G, Annunziata G, Rotondo A. Low back pain and sciatica: treatment with intradiscal-intraforaminal O(2)-O(3) injection. Our experience. Radiol Med. 2008;113(5):695-706.
Hashemi M, Poorfarokh M, Mohajerani SA, Jalili P, Akhyani V, Barikani A, Farivar F. Injection of intradiscal O2-O3 to reduce pain and disability of patients with low back pain due to prolapsed lumbar disc. Anesth Pain Med. 2014;4(5):e19206.
Lehnert T, Naguib NN, Wutzler S, Nour-Eldin NE, Bauer RW, Kerl JM, Vogl TJ, Balzer JO. Analysis of disk volume before and after CT-guided intradiscal and periganglionic ozone-oxygen injection for the treatment of lumbar disc herniation. J Vasc Interv Radiol. 2012;23(11):1430-1436.
Buric J, Rigobello L, Hooper D. Five and ten year follow-up on intradiscal ozone injection for disc herniation. Int J Spine Surg. 2014;8:17

References

Long DM. Decision making in lumbar disc disease. Clin Neurosurg. 1992; 39: 36–51.

Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000;13(3):205–217.

Gangi A, Dietemann JL, Mortazavi R, Pfleger D, Kauff C, Roy C. CT-guided interventional procedures for pain management in the lumbosacral spine. Radiographics. 1998;18(3):621–633.

Gautam S, Rastogi V, Jain A, Singh AP. Comparative evaluation of oxygen-ozone therapy and combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation for the treatment of lumbar disc herniation. Pain Pract. 2011;11(2):160–166.

Iliakis E, Valadakis V, Vynios DH, Tsiganos CP, Agapitos E. Rationalization of the activity of medical ozone on the intervertebral disc. A Histological and Biochemical Study. Rivista di Neuroradiologia. 2001;14(1):23-30.

Bocci V. Ozone: A new medical drug. 2nd ed. Dordrecht: Springer; 2011: 210-243.

Bocci V, Borrelli E, Zanardi I, Travagli V. The usefulness of ozone treatment in spinal pain. Drug Des Devel Ther. 2015;9:2677-2685.

Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M. Minimally invasive oxygen-ozone therapy for lumbar disk herniation. AJNR Am J Neuroradiol. 2003;24(5):996–1000.

Bonetti M, Fontana A, Cotticelli B, Volta GD, Guindani M, Leonardi M. Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR Am J Neuroradiol. 2005;26(5):996–1000.

Al-Jaziri AA, Mahmoodi SM. Painkilling effect of ozone-oxygen injection on spine and joint osteoarthritis. Saudi Med J. 2008;29(4):553–557.

Vaillant JD, Fraga A, Diaz MT, Mallok A, Viebahn-Hänsler R, Fahmy Z, Barberá A, Delgado L, Menéndez S, Fernández OS. Ozone oxidative postconditioning ameliorates joint damage and decreases pro-inflammatory cytokine levels and oxidative stress in PG/PS-induced arthritis in rats. Eur J Pharmacol. 2013;714(1-3):318–324.

Muto M, Avella F. Percutaneous treatment of herniated lumbar disc by intradiscal oxygen-ozone injection. Interv Neuroradiol. 1998;4(4):279–286

Muto M, Andreula C, Leonardi M. Treatment of herniated lumbar disc by intradiscal and intraforaminal oxygen-ozone (O2-O3) injection. J Neuroradiol. 2004;31(3):183–189.

Gallucci M, Limbucci N, Zugaro L, Barile A, Stavroulis E, Ricci A, Galzio R, Masciocchi C. Sciatica: Treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only. Radiology. 2007;242(3):907–913.

Muto M, Ambrosanio G, Guarnieri G, Capobianco E, Piccolo G, Annunziata G, Rotondo A. Low back pain and sciatica: treatment with intradiscal-intraforaminal O(2)-O(3) injection. Our experience. Radiol Med. 2008;113(5):695-706.

Hashemi M, Poorfarokh M, Mohajerani SA, Jalili P, Akhyani V, Barikani A, Farivar F. Injection of intradiscal O2-O3 to reduce pain and disability of patients with low back pain due to prolapsed lumbar disc. Anesth Pain Med. 2014;4(5):e19206.

Lehnert T, Naguib NN, Wutzler S, Nour-Eldin NE, Bauer RW, Kerl JM, Vogl TJ, Balzer JO. Analysis of disk volume before and after CT-guided intradiscal and periganglionic ozone-oxygen injection for the treatment of lumbar disc herniation. J Vasc Interv Radiol. 2012;23(11):1430-1436.

Buric J, Rigobello L, Hooper D. Five and ten year follow-up on intradiscal ozone injection for disc herniation. Int J Spine Surg. 2014;8:17

Author biographies is not available.