AI Article Synopsis
- The study explored the use of intradiscal ozone injections as an alternative treatment for disc herniation, with over 100 patients treated in 2002-2003 and positive short-term outcomes reported.
- At five-year follow-up, 79% of patients showed a reduction in herniation, with significant improvements in those avoiding surgery—82% at five years and 88% at ten years.
- The researchers concluded that ozone injections are a safe and effective treatment for about 75% of patients, emphasizing the need for additional randomized trials to confirm these findings.
Article 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325503 | PMC |
| http://dx.doi.org/10.14444/1017 | DOI Listing |
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