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Five and ten year follow-up on intradiscal ozone injection for disc herniation.

Buric J, Rigobello L, Hooper D - Int J Spine Surg (2014)

Bottom Line: We conclude that ozone is safe and effective in approximately 75% of patients with disc herniation and the benefit is maintained through ten years.The benefit of ozone is durable and does not preclude future surgical options.The risk reward profile for this treatment is favorable.

View Article: PubMed Central - PubMed

Affiliation: Villa Torri Hospital, Bologna, Italy.

ABSTRACT

Background: Disc herniation is the most common cause for spinal surgery and many clinicians employ epidural steroid injections with limited success. Intradiscal injection of ozone gas has been used as an alternative to epidural steroids and surgical discectomy. Early results are positive but long-term data are limited.

Methods: One hundred and eight patients with confirmed contiguous disc herniation were treated with intradiscal injection of ozone in 2002-2003. One-hundred seven patients were available for telephone follow-up at 5 years. Sixty patients were available for a similar telephone follow-up at ten years. Patients were asked to describe their clinical outcome since the injection. Surgical events were documented. MRI images were reviewed to assess the reduction in disc herniation at six months.

Results: MRI films demonstrated a consistent reduction in the size of the disc herniation. Seventy-nine percent of patients had a reduction in herniation volume and the average reduction was 56%. There were 19 patients that ultimately had surgery and 12 of them occurred in the first six months after injection. One of these 12 was due to surgery at another level. Two surgeries involved an interspinous spacer indicated by stenosis or DDD. All other surgeries were discectomies. Of the patients that avoided surgery 82% were improved at 5 years and 88% were improved at 10 years. Other than subsequent surgeries, no spine-related complications were experienced.

Conclusions/level of evidence: We conclude that ozone is safe and effective in approximately 75% of patients with disc herniation and the benefit is maintained through ten years. This is a retrospective review and randomized trials are needed.

Clinical relevance: Intradiscal ozone injection may enable patients to address their pain without multiple epidural injections and surgery. The benefit of ozone is durable and does not preclude future surgical options. The risk reward profile for this treatment is favorable.

No MeSH data available.


Related in: MedlinePlus

MRIs from two patients showing a reduction in the volume of the disc herniation after intradiscal ozone injection.
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Figure 0002: MRIs from two patients showing a reduction in the volume of the disc herniation after intradiscal ozone injection.

Mentions: In most patients, the size of the herniation was reduced at 6 months. See Figure 2. Of the 52 single level patients with MRI at 6 months, 42 (81%) had a reduction of 50% or more. Nine patients (17%) had no observable change in the herniation and three of those patients had surgery. In this series, there was no correlation between age and the reduction in herniation (R2 = 0.04)


Five and ten year follow-up on intradiscal ozone injection for disc herniation.

Buric J, Rigobello L, Hooper D - Int J Spine Surg (2014)

MRIs from two patients showing a reduction in the volume of the disc herniation after intradiscal ozone injection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325503&req=5

Figure 0002: MRIs from two patients showing a reduction in the volume of the disc herniation after intradiscal ozone injection.
Mentions: In most patients, the size of the herniation was reduced at 6 months. See Figure 2. Of the 52 single level patients with MRI at 6 months, 42 (81%) had a reduction of 50% or more. Nine patients (17%) had no observable change in the herniation and three of those patients had surgery. In this series, there was no correlation between age and the reduction in herniation (R2 = 0.04)

Bottom Line: We conclude that ozone is safe and effective in approximately 75% of patients with disc herniation and the benefit is maintained through ten years.The benefit of ozone is durable and does not preclude future surgical options.The risk reward profile for this treatment is favorable.

View Article: PubMed Central - PubMed

Affiliation: Villa Torri Hospital, Bologna, Italy.

ABSTRACT

Background: Disc herniation is the most common cause for spinal surgery and many clinicians employ epidural steroid injections with limited success. Intradiscal injection of ozone gas has been used as an alternative to epidural steroids and surgical discectomy. Early results are positive but long-term data are limited.

Methods: One hundred and eight patients with confirmed contiguous disc herniation were treated with intradiscal injection of ozone in 2002-2003. One-hundred seven patients were available for telephone follow-up at 5 years. Sixty patients were available for a similar telephone follow-up at ten years. Patients were asked to describe their clinical outcome since the injection. Surgical events were documented. MRI images were reviewed to assess the reduction in disc herniation at six months.

Results: MRI films demonstrated a consistent reduction in the size of the disc herniation. Seventy-nine percent of patients had a reduction in herniation volume and the average reduction was 56%. There were 19 patients that ultimately had surgery and 12 of them occurred in the first six months after injection. One of these 12 was due to surgery at another level. Two surgeries involved an interspinous spacer indicated by stenosis or DDD. All other surgeries were discectomies. Of the patients that avoided surgery 82% were improved at 5 years and 88% were improved at 10 years. Other than subsequent surgeries, no spine-related complications were experienced.

Conclusions/level of evidence: We conclude that ozone is safe and effective in approximately 75% of patients with disc herniation and the benefit is maintained through ten years. This is a retrospective review and randomized trials are needed.

Clinical relevance: Intradiscal ozone injection may enable patients to address their pain without multiple epidural injections and surgery. The benefit of ozone is durable and does not preclude future surgical options. The risk reward profile for this treatment is favorable.

No MeSH data available.


Related in: MedlinePlus