Aims and objectives
Intervertebral disc degeneration and disc herniation areconsidered to be the main causes of low back pain.
Percutaneous CT guided ozone (O2-O3) chemiodiscolysis is a well-estabilished minimally invasive interventional technique for the treatment of lumbar disc herniation.
The biological effect of the ozone on discoradicular pain relies on several pathways,
the most important being the reduction of disc volume acting directly on the nucleus pulposus,
because it breaks the glycosaminoglycanchains and prevents water retention,
resulting in dehydration of the disc.
Magnetic resonance imaging (MRI) is the...
Methods and materials
We evaluated 28 patients (15 male,
48.9 ± 9.6 years,
range 25-61) with sciatica from single-level lumbar disc herniation (L3-L4,
4 patients; L4-5,
13 patients; L5-S1,
eligible for O2-O3 chemiodiscolysis treatment.
All patients underwent 3T MR scan with standard morphological and T2 mapping sequences,
before and one month after treatment.
Instrumental imaging evaluation included analysis of intervertebral disc area (fig.1) and analysis of T2 relaxation time maps with ROI position at the affected disc level (fig.2).
All patients were...
According to the clinical follow-up,
O2-O3 chemiodyscolisis patients were divided into two groups: A) responders (significant VAS and ODI after treatment decrease,
respectively up to 66% and 39%; p<0.005),
Group A patients showed a significant decrease in disc-treated area and T2 values (with a positive correlation between mean difference values),
in contrast with Group B patients,
who showed lower T2 pre-treatment values.
Control group patients also showed a non-significant difference in disc area and T2 values (p-value >0.05)
This preliminary study demonstrates the correlation of higher pre-treatment T2 relaxation time values at T2 mapping imaging with disk shrinkage and improvement of clinical symptoms.
T2 mapping evaluation of intervertebral disc may be a useful indicator to predict procedural outcome and clinical response to O2-O3 chemiodiscolysis,
and could represent an inclusion criterion in the patient selection for a correct treatment planning
Hassanien M (2018) Ozone-Oxygen Injection upon the Pain Alleviation in Patients with Low Back Pain : A.
Wang J (2013) Treatment of the lumbar disc herniation with intradiscal and intraforaminal injection of.
et al (2016) Preliminary study on diagnosis of lumbar disc degeneration with magnetic resonance T1p,
T2 mapping and DWI quantitative detection technologies.
Eur Rev Med Pharmacol Sci 20:3344–3350