Intraforaminal ozone therapy and particular side effects: preliminary results and early warning

Vanni, Daniele; Galzio, Renato; Казакова, А. Н.; Pantalone, Andrea; Sparvieri, Antonio; Salini, Vincenzo; Magliani, Vincenzo

doi:10.1007/s00701-015-2545-y

Cited by 22 publications

(26 citation statements)

References 12 publications

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“…There have been serious adhesions and bone hardening in the disc region, especially after intradiscal ozone injection. 19 This is why we used paravertebral ozone injection. The ozone is rapidly dissolved in the injected region, and the bolus spreads rapidly into the tissues; it has the same effect on the area near the disc.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

et al. 2019

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Aim Paravertebral ozone injection is a new treatment method described in the literature for low back pain. The aim of this study was to compare the pre‐ and post‐treatment pain scores of patients undergoing paravertebral ozone/oxygen (O3/O2) injections for low back pain. Methods From September 2018 to December 2018, 122 patients who underwent paravertebral ozone injections due to low back pain were examined retrospectively; 62 patients who met the study criteria were included. The patients were injected with 15 µg/mL (50 mL) O3/O2 gas in the paravertebral space. The subjects were treated every 7 days for 6 total session. The VAS and Oswestry Disability Index (ODI) scores were assessed before treatment and after treatment (first and third months). The patients’ body mass indexes (BMIs) were measured before the injections. Results There were 12 male patients and 50 female patients. The mean age was 51.9 (range 25 to 71) years. The mean duration of pain was 9.1 (3 to 24) months. Significant improvements were observed in the statistical comparison of VAS and ODI scores between the pre‐injection and first month controls (P < 0.000). There was no significant difference in the statistical comparison of VAS and ODI scores between the first and third months (P < 0.05). There was no statistically significant difference between BMI and pain scores (P > 0.213). Conclusion Paravertebral O3/O2 gas is a reliable and effective treatment for the treatment of lumbar disc herniation, radicular pain, and mechanical back pain due to low back pain.

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Section: Discussionmentioning

confidence: 99%

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

et al. 2019

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“…In the musculoskeletal apparatus these characteristics make it a precious agent for the treatment of inflammatory and degenerative processes, as degenerative disc disease [9]. Ozone is delivered in a linked formula with oxygen at very low concentrations, avoiding toxic reactions: it is usually administered from 20-40 mg/mL of oxygen.…”

Section: Principles Of Actionmentioning

confidence: 99%

Intradiscal O₂O₃: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation

et al. 2017

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The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (OO) at very low concentrations for 15 years in Europe. The main indication is back pain with or without radicular pain but without motor deficits, which is refractory to 4-6 weeks of conservative therapies. Its mechanism of action on the disc is mechanical (volume reduction by subtle dehydration of the nucleus pulposis) and antinflammatory. The intradiscal ozone injection is performed with a thin needle (18-22 gauge) image guided by computed tomography or angiofluoroscopy and is usually complimented by periganglionic injection of corticosteroids and anesthetics. This combination gives immediate pain relief and allows time for the ozone to act. It is a cost-effective procedure that presents a very low complication rate (0.1%). The radicular pain is resolved before the back pain does, as is seen with microdiscectomy. Peer-reviewed publications of large randomized trials, case series, and meta analysis from large samples of patients have demonstrated the procedure to be safe and effective in the short and the long terms, with benefits recognized up to 10 years after treatment. We aim to review the principles of action of OO and report the injection techniques, complications, and short- and long-term outcomes.

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“…Another recent work reported the presence of many hard adhesions to the dural sac, and fragmented discs, in patients who received ozone injections but not steroid injections via the intra-foraminal approach (Vanni et al, 2016). Therefore, ozone therapy may induce major unwanted complications, and the development of appropriate guidelines and protocols for ozone therapy, and its application in spinal pain is warranted.…”

Section: Treatment Of Sciatica With Epidural Corticosteroid Injectionmentioning

confidence: 99%

Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain

Braidy

Izadi

Sureda

et al. 2017

Journal Cellular Physiology

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Ozone, one of the most important air pollutants, is a triatomic molecule containing three atoms of oxygen that results in an unstable form due to its mesomeric structure. It has been well-known that ozone has potent ability to oxidize organic compounds and can induce respiratory irritation. Although ozone has deleterious effects, many therapeutic effects have also been suggested. Since last few decades, the therapeutic potential of ozone has gained much attention through its strong capacity to induce controlled and moderated oxidative stress when administered in precise therapeutic doses. A plethora of scientific evidence showed that the activation of hypoxia inducible factor-1α (HIF-1a), nuclear factor of activated T-cells (NFAT), nuclear factor-erythroid 2-related factor 2-antioxidant response element (Nrf2-ARE), and activated protein-1 (AP-1) pathways are the main molecular mechanisms underlying the therapeutic effects of ozone therapy. Activation of these molecular pathways leads to up-regulation of endogenous antioxidant systems, activation of immune functions as well as suppression of inflammatory processes, which is important for correcting oxidative stress in diabetes and spinal pain. The present study intended to review critically the available scientific evidence concerning the beneficial properties of ozone therapy for treatment of diabetic complications and spinal pain. It finds benefit for integrating the therapy with ozone into pharmacological procedures, instead of a substitutive or additional option to therapy.

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Intraforaminal ozone therapy and particular side effects: preliminary results and early warning

Abstract: It is important to assert that ozone therapy procedures can be associated with several major complications. Therefore, performing a revision of the guidelines and protocols for ozone therapy application is indispensable.

Cited by 22 publications

References 12 publications

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

Intradiscal O₂O₃: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation

Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain

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Intraforaminal ozone therapy and particular side effects: preliminary results and early warning

Abstract: It is important to assert that ozone therapy procedures can be associated with several major complications. Therefore, performing a revision of the guidelines and protocols for ozone therapy application is indispensable.

Cited by 22 publications

References 12 publications

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain

Intradiscal O2O3: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation

Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain

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Intradiscal O₂O₃: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation