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1° Congresso internazionale: RUOLO DELL'OSSIGENO-OZONO TERAPIA NELLE LOMBALGIE E LOMBOSCIATALGIE.

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ESCI 2003: 37th ANNUAL SCIENTIFIC MEETING OF THE EUROPEAN SOCIETY FOR CLINICAL INVESTIFATION
Verona, Italy, 2-5 April 2003
"The Pathophysiology of Diseases: from bench to bedside"

ID 24
CT-Guided intraforaminal oxygen-ozone therapy in lumbar disc herniation
M. Bonetti, B. Cotticelli, F. Albertini, L. Valdenassi*, and P. Richelmi*Servizio di 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, Lasčgue’s 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 Three cc of oxygen-ozone mixture at 25mg/ml were injected; and the needle was then withdrawn by a few mm before injecting 7-8 cc of the gas mixture into the intervertebral joint.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 then discharged.
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.
ID 74
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, Italy
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 or physiotherapy.
1st group(10 subjects): treatment with Oxygen-ozone Therapy and spinal segmental stabilization exercises.
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 self-treatment.
ID 81
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 didn’t 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.
ID 91
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 effects.
ID 99
Ozygen-ozone therapy in disc-root compression pain syndrome: comparison with other methods
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.
ID 105
Follow-up disc-root compression and post-surgical radiculopathies with paravertebral oxygen-ozone
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 later.
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 of symptoms.
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.

ID 148
Efficacy of oxygen-ozone therapy in fibromyalgia
R. Cosentino
Dept. of Rheumatology, University of Siena, Siena, Italy
Objective: the aim of our study was to evaluate the efficacy of oxygen-ozone therapy in fibromyalgia.
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 patient.
-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.
ID 167
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.
ID 172
Advanced dressings and oxygen-ozone therapy to treat ulcer’s in chronic obliterant peripheral artheriopathies (AOCP)
M. Luongo*, L. Ferrara, G. Giordano, F. Del Genio, V. Paolella, L. Mascolo, A. Sammartino, and C. Luongo
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 patient’s quality of life.
ID 173
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), Italy
In the past 15 years about 10% of patients suffering from root – disc conflict pathology didn’t 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 patient’s 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.
ID 174
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 ozone’s 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 haven’t found the same therapeutic efficacy. Nowadays, thanks to the use of an electro medical equipment it’s 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 treated patients.
ID 175
Effects of oxygen – ozone mixture on the platelet aggregation and on the hematic viscosity
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 oxygen’s 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.
ID 197
Chemodiskolysis and periradicular and periganglionic infiltration with oxygen-ozone in disk herniation
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 oxygen-ozone
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
1.      .
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.
ID 198
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. Castriota-Scanderbeg3
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 Marmi, Italy).
ID 202
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, Italy
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 low cost.
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 involvement.
ID 230
Ozone-therapy in treatment of diabetic foot ulcers: a suggestive approach in wound bed preparation
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.