Automated Nucleotomy and Nucleolysis with Ozone

Abstract

Lumbar and radicular pain due to HNP has been described since 1934. It is thought that the pain is caused by compression and by other local chemical mediators that are present in the area of interaction between the root and the disc.With the objective of treating patients suffering from this syndrome and with a percutaneous minimally invasive approach, we designed a mixed technique: percutaneous automated nucleotomy plus nucleolysis and periradicular infiltration with ozone.A retrospective study of 105 patients was conducted, including 60 men and 45 women with an average age of 43 years. All patients were treated with that technique between November 2006 and August 2008. Clinical follow-up of 15.2 months was provided by telephone, utilizing a modified Mac Nab scale. The results were as follows: 60% excellent, 22.8% good (82.8% success), 9.6% acceptable, 7.6% poor. From the eight patients that reported poor results, five were considered to have recurrent symptoms (4.8%), because they had initially shown a period of significant improvement post operatively. Morbidity was manifested by transient pain and muscle spasms in the post operative area (2.8%).We conclude that this new mixed technique, compared to automated percutaneous nucleotomy alone, may be more widely utilized by broadening the indications, with acceptable results.

Role of percutaneous nonvascular Interventional Radiology treatments in musculoskeletal lesions

“…In percutaneous ozone treatment, mixture of ozone-oxygen gas is administered into nucleus pulposus through the needle. This mixture has a direct effect on the proteoglycans of the nucleus pulposus, resulting in release of water molecules and subsequent degeneration of matrix and reduction of volume (15) (Fig. 3).…”