MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2–O3 discolysis

Perri, Marco; Grattacaso, Giuseppe; Tunno, Valeria Di; Marsecano, Claudia; Cesare, Ernesto Di; Splendiani, Alessandra; Gallucci, M.

doi:10.1177/1971400915576658

Cited by 22 publications

(24 citation statements)

References 13 publications

(19 reference statements)

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“…We request follow-up MRI only in patients with worsening or changing symptoms to rule out the possibility of a septic discitis or the development of recent discal lesions at different levels. Studies that included both clinical and radiological follow-ups have reported a reduction of herniation volume in 63–96% of the patients at 6-month control [ 25 , 34 – 36 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ozone nucleolysis for lumbar disc herniation

et al. 2018

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PurposeAll percutaneous minimally invasive disc treatments are typically indicated to contained disc herniations. Our study’s aim is to evaluate prospectively the efficacy of ozone nucleolysis in the treatment of either contained or uncontained lumbar disc herniations.MethodsFifty-two patients, aged 27–87 years, with symptomatic herniated lumbar discs, without migration, sequestration, or severe degenerative disc changes, who failed conservative treatment, were included in our study. The patients underwent fluoroscopic-guided intradiscal oxygen-ozone mixture injection (5 ml) at a concentration of 27–30 μg/ml and periradicular injection of the same O2-O3 mixture (10 ml), steroid (1 ml), and local anesthetic (1 ml). Clinical outcomes were evaluated, based on the Oswestry Disability Index (ODI) and pain intensity (0–5) scale results, obtained initially and at 2- and 6-month controls. Our results were analyzed by ANOVA and chi-squared (χ2) tests.ResultsOur initial results obtained at 2-month control were promising, indicating a significant decrease in pain disability and intensity in 74% (37) and 76% (38) of the patients respectively, and minimally increased to 76% (38) and 78% (39) at 6-month control (P < 0.001 and CI 99.9%). The mean preprocedure ODI and pain intensity scores were 35 ± 14.36 and 2.38 ± 0.90, respectively, which were reduced to 19.36 ± 13.12 and 1.04 ± 0.92 at 6-month control. Our failure had been mostly related to long symptoms duration of more than 1 year. No complications were recorded.ConclusionOzone nucleolysis is a safe cost-effective minimally invasive technique for treatment of contained and uncontained lumbar disc herniations.

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Section: Discussionmentioning

confidence: 99%

Percutaneous ozone nucleolysis for lumbar disc herniation

et al. 2018

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“…9,10,16 The therapeutic efficacy of oxygen–ozone has been known for over 25 years, and many studies have demonstrated its validity for the treatment of herniated discs. 1,3–5,7,8…”

Section: Discussionmentioning

confidence: 99%

“…Besides being the most common cause of lumboradicular pain, it is also the most frequent indication for spine surgery. 1–13…”

Section: Introductionmentioning

confidence: 99%

MRI findings in lumbar spine following O₂–O₃ chemiodiscolysis: A long-term follow-up

et al. 2017

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Intradiscal O2–O3 injections are conventionally used as a minimally invasive treatment for lumbar disc herniation in patients not responding to conservative treatments. The aim of the present study is to report data of long-term imaging follow-up (3 years) of patients treated with intradiscal O2–O3 lumbar chemiodiscolysis. We evaluated the changes of disc volume and the modifications in disc appearance (in terms of disc degeneration) and endplate changes (according to Modic), comparing the results with a control group of patients. Our results showed a stable reduction of the disc herniation volume in patients treated compared with the control group, while we did not find statistically significant differences in terms of disc degeneration and endplate changes (Modic). We concluded that the O2–O3 discolysis, despite leading to a significant shrinkage of the disc herniation, does not involve – in the long term – biomechanical changes of the spine in terms of acceleration of the disc degeneration process in comparison with the natural course.

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“…The vertebral bodies appear hypointense on T1-weighted and hyperintense on T2-weighted images, especially with fat-saturated T2-weighted images, such as STIR [31]. The signal alterations result from microfractures and hemorrhage within the medullary bone.…”

Section: Osseous Injuriesmentioning

confidence: 95%

Thoracic spine trauma: advanced imaging modality

et al. 2016

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Technological advances in diagnostic imaging make the diagnosis of spinal trauma more accurate both in the acute and in the chronic settings. Improvements in medical care and in diagnostic imaging lead to an increasing prevalence of patients' surviving injuries. The management of these patients depends on early and appropriate radiological evaluation in the acute phase. The aim of this work was to review advanced imaging modalities employed to study thoracic spine and spinal cord in injured patients.

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MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2–O3 discolysis

Abstract: T2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.

Cited by 22 publications

References 13 publications

Percutaneous ozone nucleolysis for lumbar disc herniation

Percutaneous ozone nucleolysis for lumbar disc herniation

MRI findings in lumbar spine following O₂–O₃ chemiodiscolysis: A long-term follow-up

Thoracic spine trauma: advanced imaging modality

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MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2–O3 discolysis

Abstract: T2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.

Cited by 22 publications

References 13 publications

Percutaneous ozone nucleolysis for lumbar disc herniation

Percutaneous ozone nucleolysis for lumbar disc herniation

MRI findings in lumbar spine following O2–O3 chemiodiscolysis: A long-term follow-up

Thoracic spine trauma: advanced imaging modality

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MRI findings in lumbar spine following O₂–O₃ chemiodiscolysis: A long-term follow-up