Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation
F. Andreulab, Luigi Simonettia, Fabio de
Santisa, Raffaele Agatia, Renata Riccia
and Marco Leonardia
Department of Neuroradiology, Ospedale Bellaria, Bologna, Italy
b Ospedale Policlinico, Bari, Italy
reprint requests to Marco Leonardi, MD, Servizio di Neuroradiologia, Ospedale Bellaria,
Via Altura 3, 40139 Bologna, Italy
AND PURPOSE: Oxygen-ozone therapy is a minimally invasive treatment for
lumbar disk herniation that exploits the biochemical properties of a gas
mixture of oxygen and ozone. We assessed the therapeutic outcome of
oxygen-ozone therapy and compared the outcome of administering medical ozone
alone with the outcome of medical ozone followed by injection of a corticosteroid
and an anesthetic at the same session.
Six hundred patients were treated with a single session of oxygen-ozone
therapy. All presented with clinical signs of lumbar disk nerve root
compression, with CT and/or MR evidence of contained disk herniation. Three
hundred patients (group A) received an intradiscal (4 mL) and periganglionic (8
mL) injection of an oxygen-ozone mixture at an ozone concentration of
27 µg/mL. The other 300 patients (group B) received, in addition, a
periganglionic injection of corticosteroid and anesthetic. Therapeutic outcome
was assessed 6 months after treatment by using a modified MacNab method.
Results were evaluated by two observers blinded to patient distribution within
the two groups.
A satisfactory therapeutic outcome was obtained in both groups. In group A,
treatment was a success (excellent or good outcome) in 70.3% and deemed a
failure (poor outcome or recourse to surgery) in the remaining 29.7%. In group
B, treatment was a success in 78.3% and deemed a failure in the remaining
21.7%. The difference in outcome between the two groups was statistically
significant (P < .05).
Combined intradiscal and periganglionic injection of medical ozone and
periganglionic injection of steroids has a cumulative effect that enhances the
overall outcome of treatment for pain caused by disk herniation. Oxygen-ozone
therapy is a useful treatment for lumbar disk herniation that has failed to
respond to conservative management.