Comparing the results of intradiscal ozone injection to treat different types of intervertebral disc herniation based on MSU classification

Hosseini, Behnam; Taheri, Mohammad; Sheibani, Kourosh

doi:10.1177/1591019918800458

Cited by 5 publications

(7 citation statements)

References 17 publications

(63 reference statements)

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“…15 The disk herniation type 2AB was set as reference value in our population because it was associated with the worst outcome after OCN. This finding is in line with the previously cited article by Hosseini et al 27 where the authors found a worse result in 2AB group, probably because of the bigger size of herniation.…”

Section: Discussionsupporting

confidence: 92%

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Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation

2021

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The aim of this study was to retrospectively investigate factors predicting a successful outcome after ozone chemonucleolysis (OCN) in patients with radicular pain and poor response to conservative treatments. Methods: Univariable and multivariable logistic regression analysis was used to identify the predictors of good outcome after OCN. Good outcome was defined as 33% Oswestry Disability Index (ODI) reduction (model 1) or 13-point ODI improvement (model 2) at 1 month after OCN. Results: Two hundred seventy-three patients were analyzed. A significant pain reduction (pre-operative Numerical Rating Scale [NRS] 6.7 AE 1.5, postoperative NRS 2.6 AE 2.2, P < 0.0001) and ODI improvement (pre-operative ODI 39 AE 13.7, postoperative ODI 21.4 AE 13.8, P < 0.0001) was obtained 1 month after OCN. Pain duration (< 1 year), type of disk herniation based on Michigan State University classification (MSU), stages of disk degeneration revealed by discogram and absence of foraminal stenosis (bony or ligament flavum hypertrophy) appeared as predictors of successful outcome. Age, gender, previous spine surgery, level site of disk herniation, presence of uncontained lumbar disk herniation, and vertebral Modic changes were not statistically associated with the outcome. Both the models showed a good accuracy (model 1, area under the curve [AUC] = 0.84 AE 0.027, 95% confidence interval [CI] = 0.79 to 0.89; model 2, AUC = 0.86 AE 0.024, 95% CI = 0.81 to 0.91). Conclusions: OCN is an effective treatment for radicular pain due to disk herniation. Pain duration (< 1 year), MSU disk herniation type (1A, 1B, 1C, 2A, and 2B), disk degeneration grade 2, and absence of foraminal stenosis are all associated with the successful outcome and should be carefully evaluated before OCN. &

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Section: Discussionsupporting

confidence: 92%

“…Hosseini et al, 27 recently reported that the reduction in NRS and ODI improvement after OCN is different if the MSU classification is considered. These authors reported a worse outcome in herniated disk types 1C, 2C, and 2AB.…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation

2021

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“…Hosseini et al(2019) performed oxygen-ozone chemonucleolysis on a large number of patients with lumbar disc herniation and registered a high success rate at all types of disc herniation and failed back surgery [ 32 ]. Also several meta-analyses were published indicating the efficacy of intradiscal ozone injection in patients with disc prolapse [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative effect of transforaminal injection of Magnesium sulphate versus Ozone on oxidative stress biomarkers in lumbar disc related radicular pain

et al. 2022

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Background We aimed to investigate the effect of transforaminal injection of Magnesium sulphate versus Ozone on pain intensity, functional disability and the oxidative stress biomarkers; superoxide dismutase (SOD) and Glutathione (GSH) in patients with lumbar disc prolapse. Methods This randomized controlled trial was conducted on 135 patients having symptomatic lumbar disc prolapse, received either transforaminal injection of Magnesium sulphate with steroids, Ozone with steroids, or steroids alone. Assessment of pain severity and functional disability were done before intervention, 2 weeks, 1, 3, and 6 months after intervention. Serum SOD and GSH were measured for all included patients before and 2 weeks after intervention. Results There was a statistically significant improvement in pain intensity and functional disability 2 weeks after intervention in the three groups, but at 1-month and 3-months after intervention, the significant improvement was in Mg sulphate and Ozone groups only. At 6-months follow up, Mg sulphate group only showed a significant improvement. There was a statistically significant increase in SOD and GSH serum levels, 2-weeks after intervention in both Magnesium sulphate (P-value = 0.002, 0.005 respectively) and ozone groups (P-value < 0.001, < 0.001), but there was no statistically significant change in SOD and GSH serum levels in control group. Conclusion Transforaminal injection of Mg sulphate in patients with lumbar disc prolapse causes significant long-term improvement (up to 6 months) in pain intensity and functional disability. The serum levels of SOD and GSH were significantly increased at 2 weeks following both transforaminal injection of Mg sulphate and ozone.

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“…Ozone can be administered as a gas mixture of oxygen-ozone (medical-grade ozone), with a concentration between 10 and 40 µg/mL [23][24][25][26] . However, a study on the therapy with low (10 µg/mL), medium (40 µg/mL), and high (60 µg/mL) concentrations in patients with disc herniation showed a higher rate of decline in the group who received a volume of 40 µg/ml 25.…”

Section: Types Of Administration Doses and Concentrationsmentioning

confidence: 99%

“…However, a study on the therapy with low (10 µg/mL), medium (40 µg/mL), and high (60 µg/mL) concentrations in patients with disc herniation showed a higher rate of decline in the group who received a volume of 40 µg/ml 25. 26 . Table 1 summarizes the studies considered for long-term results.…”

Section: Types Of Administration Doses and Concentrationsmentioning

confidence: 99%

The effectiveness of percutaneous injections of ozonotherapy in low back pain

Barbosa

Sousa‐Rodrigues

Andrade

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY INTRODUCTION Lumbar pain is one of the main reasons for medical consultation, causing the disruption of daily routines due to its disabling nature, thus resulting in social and personal damage. Among the complementary treatments, ozonotherapy offers analgesia to most patients, with reports of complications. However, great questions about its clinical effectiveness have not been answered yet, and there have been reports of serious complications. OBJECTIVE To describe the use of ozonotherapy in the treatment of lumbar pain, focusing on its favorable and unfavorable effects, and its analog profile. METHODS A cross-sectional bibliographic research was performed with scientific articles obtained from the Pubmed, LILACS and Scopus database, using the following descriptors: “Ozone”, “Therapy”, “Lumbar pain”, “complication”, “Disk herniation”, “Guideline”, “Protocol”, “Standards”, “Criteria”. RESULTS The researched literature corroborates that, in clinical practice, there is safety in the use of oxygen-ozone therapy through percutaneous injections for the treatment of lumbar pain, especially when compared to surgeries and use of medicines, provided that strict criteria are followed. CONCLUSION The procedure is effective and has a favorable analgesic profile. However, it is necessary to produce a medical guideline that will help in its strict and systematic control.

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Comparing the results of intradiscal ozone injection to treat different types of intervertebral disc herniation based on MSU classification

Cited by 5 publications

References 17 publications

Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation

Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation

Comparative effect of transforaminal injection of Magnesium sulphate versus Ozone on oxidative stress biomarkers in lumbar disc related radicular pain

The effectiveness of percutaneous injections of ozonotherapy in low back pain

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