Comparison of percutaneous intradiscal ozone injection with laser disc decompression in discogenic low back pain

Abstract

BackgroundIntervertebral disc herniation with the pressure on the surrounding neural structures is one of the most important causes of chronic low back pain, which sometimes leads to open surgery. Reducing the pressure inside the disc with intradiscal intervention such as laser irradiation or ozone injection is a minimally invasive method and an alternative to surgery with satisfactory results. These two methods were compared with each other in this research.Patients and methodsIn this clinical trial, 40 patients with back pain radiating to lower limb due to lumbar intervertebral disc herniation were selected. These patients were randomly divided into two equal groups for percutaneous intradiscal intervention. The Laser Disc Decompression Group (LDG) (n=20) was exposed to 1500 J of laser irradiation into the disc center. In the Ozone Injection Group (OZG) patients (n=20), 6 mL of ozone 30 µg/mL was injected into the center of the disc. Considering the level of neural root involvement, both groups received 20 mg of triamcinolone injection via transforaminal epidural. Patients were followed up for 12 months regarding score on visual analogue scale and life performance improvement based on Oswestry Disability Index (ODI) and satisfaction level.ResultsAccording to the results, no difference was found between the two groups for ODI variable before intervention, whereas OZG showed better ODI scores in the measured time intervals. In LDG, only a significant difference in terms of ODI score was found between the times of before surgery and the first month.ConclusionIntradiscal ozone injection could be an effective and cost-effective method for treatment of patients with discogenic back pain.

Short-Term Efficacy of Epidural Injection of Triamcinolone Through Translaminar Approach for the Treatment of Lumbar Canal Stenosis

“…Many pieces of research have focused on either developing new pain management strategies or optimizing the available pain management modalities (1)(2)(3)(4)(5)(6). Back pain is a debilitating disorder with a variety of etiologies (2,(7)(8)(9). Spinal canal stenosis refers to the narrowing of the spinal canal, which results in the spinal cord and spinal nerve compression.…”

Ozone therapy with local cellular immune modulation and disc progenitor cell implant is safe, effective and efficient

“…that O 3 therapy is effective to control LBP associated to NP Herniated and/or DDD [34,[39][40][41][42][43][44][45][46][47][48][49]. The two main route of administration used were the intramuscular injection in the paravertebral muscles of the muscles innervated for the nerves of affected segments [39][40][41] and the percutaneous Intra disc injection [42][43][44][45][46][47][48][49]. Both administration route showed effi ciency to control the LBP in around 60 to 80% of treated patients with a diminishing of 60 to 75% in the VAS index.…”

“…The major cause of medical failure was and advanced degree of lumbar-sacrum osteo arthrosis related to a continuous and severe pain that lasted more than one year. Because these morphologic and clinical limitations were described by the fi rst reported treated patients [39][40][41][42][43], these 2 conditions were exclusions in the subsequent series of clinical trials [44][45][46][47][48][49].…”

“…The question arose; may the observed improvements be related with this O 3 treatment or is it the rehabilitation applied to these patients? To shed some light on this question, Appuzo, et al [45], performed an observational retrospective/ horizontal study to compare O 2 -O 3 therapy and/or Global Supporting the fi ndings of Apuzzo, et al [45], Rahimzadeh, et al [46], compared percutaneous intradiscal ozone injection with laser disc decompression in patients that suffer of discogenic LBP. VAS reduction in both groups was similar, but with a slight superiority after a year of patient follow up for O 3 threated patients [46].…”

“…These multifactorial effects of the Oxygen-Ozone therapy are the rational explanation for the high clinical effi cacy on chronic DDD. It is highly effective controlling, and even abolishing, the LBP [39][40][41][42][43][44][45][46][47][48][49]. The limitation of this therapy is that it does not affect fi brosis of the affected area, which is mainly composed of collagen type 1 which inhibits the re growing of new cartilage.…”