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Keywords:
Outcomes, Inflammation, Hernia, Treatment effects, Technical aspects, Outcomes analysis, Percutaneous, CT, Musculoskeletal spine, Interventional non-vascular
Authors:
G. Michelini, L. Sacchetti, C. Marsecano, M. Perri, A. Gennarelli, V. Felli, A. Splendiani, M. Gallucci, C. Masciocchi; L'Aquila/IT
DOI:
10.1594/ecr2015/C-1818
Conclusion
Because ozone is an unstable form of oxygen that,
in water,
reacts with organic molecules containing double or triple bonds causing an oxide reduction called ozonolysis14,
intradiscal O2-O3 mixture injection produces a chemodiscolysis of nucleus pulposus proteoglycans and dehydration followed,
finally,
by disk shrinkage and direct reduction of root compression15-16.
Another reason for using medical ozone to treat disk herniation is its analgesic and antiinflammatory effects17-18-19.
The effect of ozone on chemical radiculitis can also explain the clinical effectiveness of intraforaminal O2-O3 injection without intradiscal therapy 20.
The reported effectiveness of the procedure is promising,
with clinical success in 70%–80% of patients21.
In our study the results were 106 of 257 patients (approximately 42% ) and 89 of 257 (approximately 35%) had successful outcomes (the responders respectively with discal extrusions and protrusions) while 14 patients in a total of this groups showed unsatisfactory results(the non-responders) both with an follow-up period of 6 months.
In our experience there was no significant difference between the responders and non-responders to oxygen-ozone(O2-O3) discolysis in the presence of bulging disk (p > 0.01).
In addition there was no significant difference in terms of moderate degeneration and dehydratation disk but in the case of low degenerated disc the success of rate was statistically significant(p < 0.01) in 185 patients of 257. Therefore we can assume that in our experience oxygen-ozone chemodiscolysis obtains the best results in the case of extrusions and protrusions.
In selected patients,
even disc pathologies associated with discal degenerative can be treated,
with some success.
In patients with more severe degenerative changes got worse results,
even if with a transient efficacy.