Oxygen-ozone(O2-O3) discolysis is a good alternative to surgical treatment for lumbar disc herniation for patients failing to respond to conservative treatment,
with a successful percentage of 70-80% without complications[1-2].
The basic principle of action of intradiscal injection of oxygen-ozone(O2-O3) mixture,
is the reduction of proteoglicans,
consequent dehydration and shrinkage of the disc but no study has been published on an analysis of these changes in MRI.
Since there is good evidence that DWI hasimproveddiagnostic accuracyfor detecting diffusibility water reduction in degenerative disc disease we assumed...
Methods and Materials
Patients- Between June 2012 and January 2013 a total of 154 patients(89 men and65 women,
mean ageat presentation was 44),
with story of low back pain related to lumbar disc herniation for at least 4 weeks with no or poor clinical improvement after conservative therapy,
were selected for the protocol of prospective double-blind trial.
Based on an assessment of the visual analog scale (VAS) ranging from 0 to 10,
only patients with initial pain value above the cut-off of 3 were included in our study...
Comparison of Study and Control Group- At the presentation,
the study and control groups (Table 1),
were not significantly different (P=0.58 to P=0.74) in terms of demographic data( sex,
disc level affected and BMI).
For 11 patients from the study group,
no matching control subject could be found,
resulting in 66 matched pairs(Table 1).The treatment at 2 months was a success in 15(19.5%) of 77 study group patients (95% CI: 11.3%,
30.08%) and in 14(18.1%) of 77 control group patients (95% CI: 10.3%,
Intradiscal O2-O3 mixture injection produces a chemodiscolysis of nucleus pulposus proteoglycans and dehydration followed,
by disc shrinkage and direct reduction of root compression.
we observed significantly reductionin ADC of the treated discs around the second month and herniation volume reductions around the sixth month of follow up, after oxygen-ozone(O2-O3) discolysis,
more frequent in the responders group than in the non responders group.
In our experience the finding of a statistically significant decrease in the ADC of discs after ozone therapy could be explained...
1. Guarnieri G.Vassallo P.Pezzullo M.G.Laghi F.Zeccolini G.Ambrosanio G.
Galasso R.Muto M.Izzo R.
A Comparison of Minimally Invasive Techniques in Percutaneous Treatment of Lumbar Herniated Discs The Neuroradiology Journal 22: 108-121,
Leonardi M et Al: Minimally invasive oxygen-ozone therapy for lumbar disk herniation.
Am J Neuroradiol 24: 996-1000,
Rationalization of the activity of medical ozone on intervertebral disc: a histological and biochemical study.
Riv Neuroradiol 2001;14(suppl 1):23–30.