|La societa' scientifica comunica che e' a disposizione dei
propri associati in regola con l'iscrizione per il 2001
il Protocollo Generale sull'utilizzo dell'Ossigeno Ozono per le varie patologie.
Peraltro il Comitato Scientifico puo' autorizzare variazioni comunicate dai
colleghi previa un'analisi approfondita delle variazioni o indicazioni proposte.
ATTENZIONE: il non seguire il
Protocollo redatto e/o approvato dal Comitato Scientifico della Societa' pone qualsiasi
associato immediatamente al di fuori dell'associazione stessa.
1° Congresso internazionale: RUOLO DELL'OSSIGENO-OZONO
TERAPIA NELLE LOMBALGIE E LOMBOSCIATALGIE.
ESCI 2003: 37th ANNUAL SCIENTIFIC MEETING OF THE EUROPEAN SOCIETY FOR CLINICAL
Verona, Italy, 2-5 April 2003
"The Pathophysiology of Diseases: from bench to bedside"
CT-Guided intraforaminal oxygen-ozone therapy in lumbar disc herniation
M. Bonetti, B. Cotticelli, F. Albertini, L. Valdenassi*, and P.
Neuroradiologia Istituto Policlinico San Donato Milanese, *
Istituto di Farmacologia II - Universitą di Pavia, Milano/Pavia, Italy
Background: In recent years, there have been an increasing number of reports on the use of
oxygen-ozone therapy in disc-root conflict caused by disc
herniation. In addition, different
routes of administration have been devised to inject the gas
mixture: the so-called classical
technique of paraspinal intramuscular injection, endoscopic or CT-guided intraforaminal
administration and direct intradiscal infiltration.
Materials and methods: This paper assesses the therapeutic efficacy of CT-guided
intraforaminal injection of an oxygen-ozone mixture in patients with disc-root pain caused by
lumbar disc herniation. We have treated 368 patients between October 1998 and December 2002. A
complete resolution of symptoms was achieved in 311 cases (84.5 %). On enrolment, a clinical
chart was prepared specifying name, date of birth, date of enrolment, date of first treatment
and clinical information on type of pain, irradiation, possible paraesthesias, Lasčgues
sign, degree of sensitivity, lower limb reflexes, plantar and dorsal extension of the foot and
dorsal extension of the big toe. All patients had undergone CT or MR investigation with a
diagnosis of non-calcified disc herniation. All patients with multiple hernias and those who
had undergone surgery were excluded. The number of treatments was also specified ranging from
a minimum of one session to a maximum of four. CT scan was performed at the outset to
establish the point of injection at skin level and then the distance between this point and
the root foramen was measured. Local anaesthesia was given by ethyl chloride spray. CT scans
were then used to check the correct positioning of the needle whose tip must be 4-5 mm from
the foraminal region. Three cc of oxygen-ozone mixture at 25mg/ml were injected; and the
needle was then withdrawn by a few mm before injecting 7-8 cc of the gas mixture into the
intervertebral joint. Another CT scan was then performed to ascertain the correct distribution
of the oxygen-ozone mixture. Patients were kept under clinical observation for two hours and
Results: The clinical benefit of treatment was immediate. The mechanism of action of
oxygen-ozone therapy remains unsettled. The treatments may have a direct effect on the
mucopolysaccharide chains in the nucleus pulposus, leading to oxidation and release of water
molecules resulting in a mechanical resolution of disc-root conflict.
Many indirect mechanisms are also known including anti-inflammatory, analgesic and eutrophic
effects with a reduction in disc degeneration and decongestion of the nerve roots.
Conclusion: We conclude that CT-guided oxygen-ozone injection is a highly effective treatment
for lumbar disc herniation.
Spinal segmental stabilization and oxygen-ozone therapy for lumbar discal hernia
Controlled, multicentric, randomised study.
preliminary resultsM. Monticone, A. Barbarino, R. Garri, L. Valdenassi, P. Richelmi, F.
Bertč, and A. Moschi
Surgery Department, Physiotherapy and Rehabilitation Section, University of Pavia , Pavia,
Background: Discal Hernia is considered one of the most causes of acute and subacute lumbar
pain, accompanied by a strong decrease in the quality of life.
Materials and methods: Controlled, multicentric, randomised trial. 20 patients were chosen
with an average age of 43.
Criteria of inclusion: no cognitive deficiencies, clinical and neuroradiological signs of
Lumbar Discal Hernia, algia present for between two and six months, no response to medication
1st group(10 subjects): treatment with Oxygen-ozone Therapy and spinal segmental stabilization
2nd group(10 subjects): Oxygen-ozone Therapy. Both groups: 8 fortnightly sessions and the
administration of Ozone by means of paravertebral penetration at a concentration of 20 m/ml.
Before the start, at the end and at the three-month follow-up, every patient was assessed for:
pain at rest (VAS), pain during movement (VAS), articular movements.
Results: Analysis of the results showed a reduction in pain and an increase in flexibility, in
the 1st group (p<0.03) and in the 2nd group (p<0.05). At the follow-up the significance
remained at (p<0.05) in the 1st group. Comparison showed the results to be in favour of the
first group (p<0.01).
Conclusions: Spinal segmental stabilization exercises accompanied by Oxygen-ozone Therapy are
shown to have positive results. Our study, although preliminary, has brought to light the
concrete possibility of functionally managing pain caused by Lumbar Hernia, at both acute and
subacute stages, thus allowing the doctor and physiotherapist to use rehabilitation techniques
based on accurate clinical reasoning and providing the patient with the possibility of daily
O2-O3-therapy of non-healing foot and leg ulcers in diabetic patients
A.Bearzatto*, F.Vaiano**, and M, Franzini**
*Department of Medicine 1°, Pordenone, **Italian Society of O2-O3 Therapy, Pordenone, Italy
Backgrond: Non-healing ulcers of foot end leg in diabetic patients need an appropriate
diagnosis and treatment to avoid complications. However, limb amputation represents a
significant concern for most patients with diabetes. It is so justified resorting to new
techniques to improve outcome. Ozone gas has acknowledged properties of antisepsis,
vessel-dilatation, activation of granulation-tissue, and neoangiogenesis.
Materials and methods: Sixty diabetics patients with non-healing foot/leg ulcers underwent
treatment according to Diabetic Foot International Consensus. O2-O3-therapy
according to guidelines recommended by the "Italian Society of Oxygen-Ozone Therapy"
was initiated in patients lacking any healing four weeks after conventional therapy.Either a
local soft hyperbaric atmosphere of O2-O3 or a local superficial infiltration with little
quantity of O2-O3 were adopted. Treatment sessions were conducted one to three times per week.
Patients were evaluated after eight medication sessions. Non-healing ulcers were classified
according to TWCS. Common clinical and biological parameters were evaluated.
Results: 58 type 2 and 2 type 1 diabetic patients (males 44, females 16) underwent 1 to 42
medication sessions (mean 12.1). Mean age was 67.5 years (25-95). 6 Patients didnt
complete treatment. 21-(38.9%) patients had complete recovery. 8-(14.8%) patients had a good
improvement (healing >50% of the surface). 16 patients had poor improvement (healing
<50% of the surface). 3 patients had no changes. 6 patients developed ulcer worsening.
Ulcers at stage A and B and at grade I and II according to TWCS had a better outcome.
Conclusions: Good outcomes should encourage O2-O3-therapy regimens in diabetic patients with
non-healing foot and leg ulcers.
New aspects of oxygen-ozone therapy
P. Richelmi, L. Valdenassi, and F. Bertč
Departement of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
Ozone, a triatomic molecule of oxygen, is primarily known for its role in protecting the earth
against UV sunrays. Thanks to its high oxidizing capacity and its specific reactivity it is
used industrially and medically as 02/03 mixture. It has been recently reported that
antibodies produce the chemical oxidant hydrogen peroxide which is lethal to bacteria, with
different mechanisms of action.
Certainly the most surprising recent results published in Science (November 14, 2002) was that
antibodies appear to make ozone, this was detected through its chemical signature. It has not
yet demonstrated conclusively that what was found is ozone, but the authors are highly
confident that ozone is what the antibodies are producing because no other known molecule has
the same chemical signature. Therefore the oxygen-ozone mixture may be used in therapy because
it induces: a) inactivation of bacteria, viruses, fungi, yeast and protozoa; b) enhancement of
circulation; c) stimulation of oxygen metabolism; d) formation of peroxides.Some authors have
demonstrated the positive effects of oxygen-ozone therapy in circulatory disorders, such as
peripheral arteropathy and degenerative retinic maculopathies, in erniated vertebral disk, in
articular alterations, in ulcers of the lower limbs, in osteoporosis, and in liver diseases.
We must therefore consider that the oxygen-ozone technique shows greater efficiency, and
greater acceptability, as compared with other therapy, without appreciable risks of adverse
Ozygen-ozone therapy in disc-root compression pain syndrome: comparison with other
A. Gjonovic, E. Montimara, T. Girotto, P. Richelmi.*, and L. Valdenassi*
OU Pain and Palliative Therapy, ASL 16, Regione Veneto, Dpt. Of Internal Medicine and
Therapeutics, University of Pavia, Pavia, Italy
Background: Oxygen-ozone therapy by paraspinal intramuscular injection is a method used in
recent years for the treatment of sciatica with effective results.
We assessed effectiveness of this therapy in comparison with peridural cortisone
administration and paraspinal intramuscular treatment with only local anaesthetic.
Material and methods: We studied 90 patients with lumbar pain and sciatica relating to
disc-root compression; they were divided in 3 groups as much as possible homogeneous for
initial intensity pain, for his irradiation and hernial compression seat. The first group was
treated with oxygen-ozone (paraspinal bilateral injection with 15-20 ml of gas for side at 15
mg/ml concentration in 8 sessions for 20 days). The second group of patients were treated with
3 peridural injections (15 ml physiological solution with desamethasone phosphate 8 ml) always
for 20 days. The last group was treated with bilateral injection of 10 mg bupivacaine 0,25% in
the same seats of oxygen-ozone injection.
Results: Analysis of results has demonstrated a success percentage of 75% in oxygen-ozone
group, of 55% in peridural cortisone group and 25% in local anaesthetic group.
Conclusions: This confirm a real clinical effectiveness of oxygen-ozone therapy in lumbar pain
and sciatica relating to disc hernia especially in comparison with the third group; peridural
cortisone administration is real effective but in lower percentage in comparison with group
treated with oxygen-ozone.
Follow-up disc-root compression and post-surgical radiculopathies with paravertebral
L. Valdenassi, G. Nardelli, P. Richelmi, and F. Bertč
Dept. of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
Background: Disc-root compression is increasingly treated by oxygen-ozone injections following
the positive outcome of therapy reported in the literature. The aim of the current study is
the presentation of the effects of oxygen-ozone therapy relating to a clinical follow-up.
Materials and methods: We assessed the validity of this therapy in a prospective study on 240
patients (two groups according to etiopathogenesis): group 1: 188 patients with herniated disc
and disc-root compression, group 2: 52 patients with radiculopathy related to post-surgical
fibrosis. All patients have received paravertebral injections with oxygen-ozone in 10
sessions. Outcome was analysed with clinical test, subjective evaluation and TC. All specifics
symptoms were examinated after therapy, then 6 months later and so again 1 year and 4 years
Results: Were obtained excellent results in the first group: 95 patients (51%) have complete
or marked resolution of symptoms; goods results in the second: 65 (35%) with major reduction
of symptoms and little or no benefit 28 (15%).
Among second group the results were not as good: excellent results were obtained in 17
patients (33%), good in 15 (29%). Whereas negative results in 18 patients (35%).After 1 year
results were the same, only 2 patients of the first group and 5 of the second have relapse of
symptoms. After 4 years 6 patients of the first group and 5 of the second demonstrated relapse
Conclusions: According to analysis of follow-up, oxygen-ozone therapy is an effective
treatment for disc-root compression and post-surgical radiculopathy also after a long time.
Efficacy of oxygen-ozone therapy in fibromyalgia
Dept. of Rheumatology, University of Siena, Siena, Italy
Objective: the aim of our study was to evaluate the efficacy of oxygen-ozone therapy in
Methods: Thirty female patients, 30 to 50 years old and affected with fibromialgia, were
examined. Each patient underwent a cycle of oxygen-ozone therapy of two treatments per week
for eight weeks. All patients were informed of and consented to the treatment methods. A
random, single blind study was carried out: a blood sample of 250 cc was taken from each
-For 10 patients the blood was enriched with a oxygen-ozone in a variable concentration of
from 20 to 40 oxygen-ozone and reinfused
-For 10 patients the blood was enriched with oxygen only and reinfused
-For 10 patients the unmodified blood was reinfused.
The variation of painful symptomatology were evaluated with the Visual Analogue Scale
(VAS)with examination in basal condition, at the end of the treatment, and a month tha and of
the treatment. The level of significance of the differences between the three groups of
patients was evaluated using the t-test for paired data.
Results: a statistically significant improvment in painful symptomatology was noted in
patients that underwent oxygen-ozone therapy. The reduction in painful symptomatology observed
in patients that underwent oxygenated autohemoinfusion was not significant, and no improvement
was noted in patients that underwent autohemoinfusion with unmodified blood.
Conclusion: our results show that oxygen-ozone therapy can be considered a valid alternative
therapy in the treatment of fibromyalgia.
Intrasacral epidural injection with oxygen-ozone for the treatment of low back pain.
Comparison and evaluation with other techniques and rehabilitation and return to work.
I. Mattozzi, Gp. Laurini, G. Muzzi,M. Franzini*, and A. Bigiotti
Department of Anesthesia, Reanimation ASL Viterbo, Italy; *T. Oxygen Ozone Therapy University
of Pavia, Pavia, Italy
Background: Low back pain caused by hernia and/or protrusion of the disks L4-L5 and or L5 S1
is among the most frequent causes of abstention from work in Western Countries.The caudal
epidural block is often used in the treatment of chronic pain.
Materials and methods: We administered an intrasacral epidural injection to a group of
patients, all of whom were free-lance workers affected by low back pain, using a mixture of 20
ml of O2 O3 to the concentration of 20 µgr/ml by means of the medical device Multiossigen
Medical 99 IR, ISO 9002. This methodology has been compared with others and evaluation has
been made in terms of rehabilitation and a speedy return to work.
Result: The Intrasacral epidural injection with O2-O3 has shown a greater effect on the pain
and a greater effectiveness in allowing the patient to return to his normal working activity.
Conclusions: In experienced hands, this easily used technique which carries no risk of
neurological damage, represents a valid opportunity for the patient to return to his
work-place in the briefest time possible.
Advanced dressings and oxygen-ozone therapy to treat ulcers in chronic
obliterant peripheral artheriopathies (AOCP)
M. Luongo*, L. Ferrara, G. Giordano, F. Del Genio, V. Paolella, L. Mascolo, A. Sammartino, and
Clinica Villa dei Fiori, Serv. Di terapia Iperbarica e Ozonoterapia, Acerra (Naples), Italy
Background: Aim of this study was to verify combined use of Advanced Dressing and Oxygen-Ozone
Therapy to treat AOCP patients with ulcers of various Fontain-scale values. Ulcers are
consequences of hypoxic and ischemic tissue conditions, usually associated and complicated by
a bacterial infection. When pO2 in tissues is < 20 mmHg tissue start to
degenerate and ulcer appear.
Materials and methods: During the study we considered 50 patients presenting ulcers of grade
III-IV in the Fontain Scale, according to clinical and instrumental evaluation. 25 of the
above patients received a high volume ozoneized auto-hemotransfusion, 1-2 times a week,
according to ulcers severity. The same patients were also treated with different type of
advanced dressings based on infections severity, exudates, scab, and granulation tissue.
Dressing change frequency was based on patients and ulcers conditions. The control group was
composed by patients similar in ulcers and systemic conditions, treated with high volume
ozoneized auto-hemotransfusion such as the first group of patients. Standard, traditional
dressings were used.
Results: Remarkable reduction in healing or improvement time was noticed in the first group of
patients compared to control group.
Conclusion: The results obtained suggest that the combined use of Oxygen Ozone therapy
and advanced dressings can significantly reduce the ulcers healing time and improve the
patients quality of life.
Postural diagnosis importance in the root disc conflict pathology
L. Mascolo, A. Sammartino, M. Luongo, V. Villani, C. Cipollaro, and C. Luongo
Clinica Villa dei Fiori, Serv. Di terapia Iperbarica e Ozonoterapia, Acerra (Naples),
In the past 15 years about 10% of patients suffering from root disc conflict pathology
didnt respond positively to an infiltration therapy based on oxygen-ozone mixture
administered 2 times a week.
Today we can verify, using a complete examination which includes bone and articular system,
muscular, tendineous, nervous and vascular systems, that the painful symptoms of the root
disc conflict pathologies can be due or sustained by pathologies of the
temporal-mandible joint and/or changes of the plantar arch support.
The above-mentioned examination consists of the step emission of electric impulses (6v) from
electrodes applied on the patients head, hands and feet.
A dedicated software is able to collect and analyze the impulses steps pattern. The software
is able to produce a diagnosis based on a known pattern similarity.
Using this system we can verify that many pathologies of the loin-sacral area are caused by a
postural ascending change and/or a so-called descending change of the temporal-mandible joint.
The system allows the definition of the most correct dosage of the oxygen-ozone mixture we
have to seep through in the areas indicated by the system itself.
New diagnostic therapeutic approach in chronic hepathopathic patients post HBV
and HCV necrotics
A. Sammartino, P. Esposito, L. Mascolo, M. Luongo, V. La Mura, and C. Luongo
Clinica Villa dei Fiori, Serv. Di terapia Iperbarica e Ozonoterapia, Acerra (Naples), Italy
Background: The ozone is a strong oxidizer, thus it has some antiviral, antibacterial and
antimicotic characteristic. For this reason we want to test to verify the ozones
antiviral activity on patients suffering from post necrotic ECA deriving from HBV and HCV.
Materials and methods: The use of the standardized protocols allowed us to verify on a wide
case histories the positive therapeutic response in the HBV hepatopathic patients setting as
end-point the viral replication indexes and the biohumural parameters.
Results: In the HCV, as a result of the various pathogenesis, even setting the same end point,
we havent found the same therapeutic efficacy. Nowadays, thanks to the use of an electro
medical equipment its possible to capture the alterations of potentials oxide reductions
as well as allow the elaboration not only of a systemic diagnostic direction but also the
redox potential on the hepatosplenic axe and vessels. All this above, allowed the definition
of a tailored therapeutic protocol, which allows personalizing the oxygen-ozone mixture to
dose on a patient basis.
Conclusion: This diagnostic - therapeutic system, used on about one hundred patients so far,
let us observe a disappearance or a significant reduction of the viral charge in about 90% of
Effects of oxygen ozone mixture on the platelet aggregation and on the hematic
C. Luongo, A. Coppola*, A. Sammartino, L. Mascolo, M. Luongo, and L. Coppola
Clinica Villa dei Fiori, Serv. Di terapia Iperbarica e Ozonoterapia, Acerra (Naples), Italy
The oxygen-ozone therapy, under the form of cycles of ozonized big volume self
transfusion, is used for about 20 years before the treatment of chronic, obliterant peripheral
artheriopathies (AOCP) with satisfying results.
Such results where interpreted both as conseguence of an increased oxygen release to tissues
by red corpuscles, due to an increase of 2-3 difosfoglicerato derived from the accelerate
glycolyses (ozone induced) for the oxidation of coenzymes NADH and NAPH, and as an
improvement of reologic properties of blood (reduced hematic viscosity, increased
herythrocites deformability) due to changes of cellular membranes and to proteinic lipidic
components of plasma.
Changes caused by oxygens free radicals to the various biochemical structures (the so
called oxidation damage) are today considered, by different authors, as the basic
mechanism of several pathologies ranging from inflammation to cancer; from the dementia
syndrome to the ageing itself, thus, in oxygen ozone therapy sector, there is the need for a
more clear dosage definition, to ensure the choice of ozone concentrations surely efficacious
and at the same time, far away from any potential toxic effect. According to the above
concepts, this research had the objective to evaluate the influence of various ozone dose on
the hematic viscosity and on the platelets aggregation. These parameters are of paramount
importance in the pathogenesis and in the clinic evolution of the atherosclerotic disease.
Chemodiskolysis and periradicular and periganglionic infiltration with oxygen-ozone in disk
C. Andreula1, M. Leonardi2, and M. Bonetti3
1Neuroradiology, a.o. Policlinico-consorziale, Anthea Hospital, Bari, Italy; 2Neuroradiology
a.o. Bellaria, Bologna, Italy; 3Neuroradiology Gruppo San Donato (Istituto Clinico
Cittą di Brescia,Iistituto Policlinico San Donato Milanese), Italy
Background: The success in surgically operated patients for lumbar-sacral disk herniations is
about 80-85%, for the Failed Back Surgery Sindrome with severe symptoms in 20%. For these
results new techniques (spinal procedures) were considered to reduce the surgical approach and
the undesired infectious complications. We report our experience with chemodiskolysis with
Material, method, results: In a 2-years period we treated more than 1000 patients by
Chemiodiskolysis and periradicular and paraganglionic infiltration with Oxygen-ozone mixture,
excellent and good results in 74% and unsatisfactory (bad) results in 26%. We do not report
any complications: diskitis may occur but strict surgical asepsis of the procedure will avoid
it. The patients who fail to benefit from this percutaneous treatment are referred to surgery
without any negative effects.
Conclusions: The mechanisms of ozone action are: 1. Reduction of the volume of the nucleus
pulposus, 2. Reduction of the inflammation for oxidative action on the pain mediators, 3.
Better microcirculation: the sensitive nervous roots are sensible to hypossia
The good results achieved using this techniques, with very low risk of complications and very
low cost, suggest chemodiskolysis and periradicular and periganglionic infiltration with
oxygen-ozone mixture as the procedure of choice, in patients with sciatica for contained disk
herniation without any motor symptoms.
Combined effect of O2/O3 and GPR in treatment of lumbar disc herniation. Anatomical, clinical,
and patient-self-report evaluation
D. Apuzzo1, M. Franzini2, L. Di Lucente3, M.C. Gioia3, A. Cerasa3, U. Sabatini3, and A.
2Dept. of Physical Medicine and Rehabilitation, University di Pavia, 1Studio Medico Apuzzo,
Rome, Italy, 3 Fondazione IRCCS Santa Lucia, Rome, Italy
Background: Experimental studies indicate that the O2/O3 increases the micro-vascular
activity, induces neo-angiogenesis and facilitates the elimination of toxic metabolite. Global
Postural Re-education (GPR) re-equilibrate posture by training the muscles of the spine. We
evaluated the anatomical clinical and patient-self-report effects induced by combined O2/O3
and GPR treatment of lumbar disc herniation.
Materials and methods: We studied 40 patients suffering from lumbar disc herniation. They were
assessed before and after combined O2/O3 and GPR treatment with MRI, Valleix points, Lasegue
test, Role functioning Physical and General Health sub-scales of SF-36 test and
numeric-non-verbal scale for pain evaluation. The O2/O3 infiltration and the GPR were repeated
for about 22 times at different frequency along 6 months.
Results: Post treatment MRI revealed that 47% of patients had a reduction of the hernia
volume. The clinical outcome showed a significant reduction of symptoms (Valleux points
p<0.0001 and Lasegue test p<0.001). Mainly each patient had reduction of pain
(p<0.0001) and did improve his quality of life (p<0.001) i.e. work or daily activities
had been resumed to pre-symptomatical levels.
Conclusions: It has to be point out that the percentage of hernia volume reduction of those
patients who underwent any conservative treatment is similar to the percentage reduction we
found in our series. Nevertheless, combined O2/O3 and GPR significantly reduce the feeling of
pain and do improve the quality of life in these patients.
(Preliminary data of this study have been presented to the ASOO, November 2002, Forte dei
Clinical experience in the treatment of lumbar and cervical disk disease, knee
arthritis and "frozen" shoulder, by injection of an oxygen-ozone mixture
G. Torri, and *F. Vaiano
Orthopedic clinic-Milan University, Milano, Italy; *Member of the National Board of SIOOT,
Background: Ozonetherapy has found many applications in treatment of various orthopedic
pathologies, and that's for its poor invasivity, the absence of secondary effects and for the
Materials and methods: 290 patients ageing between 23-80 years (range:35,5y)of wich 150 men
and 140 women, has been treated for different spine disk abnormalities (disk protrusions and
contained herniations, 20 ex- truded herniations,32 relapses of disk herniations)in 50 cases
joined with asymptomatic spinal canal stenosis or facet joints arthritis.12 patients were
treated for cervical spine disk disease, 8 patients for knee arthritis with synovitis and 8
for "frozen" shoulder syndrome. Patients affected by spinal disk disease have been
treated for 12 session by two bilateral injections into paravertebral muscles, at the
level of the discopathy, with an oxygen-ozone mixture; ozone concentration was of 20mcg/mlo2
for lumbar spine disk disease and of 10mcg/mlo2 for cervical spine. For knee arthritis and
"frozen" shoulder, patients were treated with 6-10 injections of an O2-O3 gaseouse
mixture (ozone concentration: 10mcg/mlo2)once a week.
Results: global evaluation has shown good and excellent results in 60%of lumbar and cervical
disk disease, a mild and subjective improvement in 30% and fair results in 10%of cases.
Excellent results were observed in patients treated for knee arthritis, while only poor
results in patients affected by "frozen" shoulder.
Conclusion: despite a very high percentage of good result in spinal disk diseases, there is
still to be clarified some mechanisms of action of a mixture of o2-o3 on spinal nerve root
Ozone-therapy in treatment of diabetic foot ulcers: a suggestive approach in wound
R. Anichini, A. De Bellis, L. Butelli, M. Gioffredi, R. Gori, R. Picciafuochi, S. Nannelli, R.
Rossetti*, and L. Alviggi
Diabetes Unit, *Microbiological Dept AUSL 3 Pistoia General Hospital, Pistoia, Italy
Background: Nonhealing foot ulcer is a common and expensive complication in diabetic patients
and may lead to amputation. Recently, an efficacious wound bed preparation
has become one of the most important aspects in healing of chronic wounds. The aim of the
present study was to investigate the effects of local ozone-therapy in the treatment of
diabetic foot ulcers.
Methods: Thirty-four diabetic patients (21 males) with chronic foot ulcers were investigated.
The mean age was 58±13 years and the mean diabetes duration 20±13 years. All patients
leasions were classified with Texas wound classification system and all patients were in stage
1 or higher and with different grade of infection, ischemia or both together. They are all
treated with local ozone-therapy twice or three times a week. Results: 53 % of patients
treated with ozone therapy healed their wounds in twenty weeks, 34% reduced their wound
surfaces in rate more than 50%. In 18% ozone therapy seems to be not effective in wound
healing, but in all case it was noted a decreased bacterial burden, a reduction of exudate
(wound exudates Score Wound Rep Reg 2000; 8:347-352), control edema and a speeded stimulation
of granulation tissue.
Conclusions: Adjunctive Ozone-therapy seems to modify the natural history of wound bed
preparation, to accelerate the healing rate of ulcers and reduce, at the same time, the
need of amputation and increase the number of wounds completely healed. Additional studies are
needed to further define the role of Ozone-therapy, as a part of a multidisciplinary program
and reduce amputation rate.