Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation

Abstract

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. &

Radiation Exposure during Fluoroscopy-Guided Ozone Chemonucleolysis for Lumbar Disc Herniation

“…Second, the authors did not specify if they performed a discography while using fluoroscopy for OCN. As we previously reported, disc degeneration grade is strictly related to the outcome after OCN [17]. In our patients, we found a radiation exposure about three times less than that reported by Somma et al for patients who underwent fluoroscopy-guided OCN.…”

“…The OCN technique was extensively described in our previous publication [17]. Briefly, after antibiotic prophylaxis, patients are placed in a prone position, and a conscious sedation is induced.…”

O uso da ozonioterapia para doenças autoimunes: esclerose múltipla e artrite reumatoide

“…A ozonioterapia é aplicada em diversas doenças, aproveitando suas propriedades antiinflamatórias, estimulantes circulatórios, virucidas e bactericidas (HU et al, 2018;KADIR et al, 2020;LEONI;CARUSO;MICHELI, 2021).…”