Medical ozone therapy in facet joint syndrome: an overview of sonoanatomy, ultrasound-guided injection techniques and potential mechanism of action

Latini, Eleonora; Curci, Enrico Roberto; Nusca, Sveva Maria; Lacopo, Alessandra; Musa, Francesca; Santoboni, Francesca; Trischitta, Donatella; Vetrano, Mario; Vulpiani, Maria Chiara

doi:10.4103/2045-9912.318859

Cited by 7 publications

(8 citation statements)

References 54 publications

(73 reference statements)

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“…Further, the paravertebral application of the O 2 -O 3 mixture is used on both the lumbar and cervical spine; this treatment can be effective in treating pain even in patients diagnosed with intervertebral HD [ 36 , 44 ]. It is also possible to use the application of O 2 -O 3 mixture in the treatment of facet joint syndrome [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review

Jandura,

Vajda,

Cech

et al. 2024

JPM

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Minimally invasive oxygen–ozone (O2-O3) therapy utilizing the biochemical effects of O2-O3 mixture is commonly used in the treatment of musculoskeletal pain. The literature dealing with O2-O3 therapy of spinal pain focuses mainly on the lumbosacral region. The aim of this review is to evaluate the efficacy of O2-O3 therapy in musculoskeletal pain in the neck region. The Medline (PubMed), SCOPUS, Web of Science, and Google Scholar databases were searched for clinical studies, using the free text terms: ozone, neck, cervical, spine, pain, disc, hernia, nucleolysis, paravertebral, treatment, and various combinations of them. In total, seven studies (two randomized controlled trials and five observational studies) were found. These studies dealt with the intradiscal or intramuscular paravertebral application of O2-O3 mixture in patients with myofascial pain syndrome, cervical disc hernias, and chronic neck pain. All these studies proved a significant decrease in neck pain (evaluated by Visual Analog Scale or Numerical Rating Scale), and most of them showed improvement in functional status (measured by Oswestry Disability Index or Neck Disability Index). In addition, other pain assessment scales and function and quality of life measures (DN4 questionnaire, pain pressure threshold, cervical lateral flexion range of motion, Japanese Orthopedic Association scale, 12- and 36-Item Short Form Surveys, modified MacNab criteria, and analgesic drug intake reduction) were used. Changes in these measurements also mostly supported the efficacy of O2-O3 treatment. No significant complications of the treatment were reported. The available evidence is sparse, but despite this, the O2-O3 treatment of musculoskeletal neck pain can be considered potentially beneficial and relatively safe.

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Section: Discussionmentioning

confidence: 99%

Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review

Jandura,

Vajda,

Cech

et al. 2024

JPM

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“…The puncture is performed by following the tip of the needle with the short side of the probe. Finally, the needle progresses with a lateral-to-medial trajectory towards the final target, which is the hypoechoic space center between the articular surfaces [58,60]. In addition to fluoroscopy (Figure 7) and CT, US can guide the procedure successfully.…”

Section: Facet Joint Approachmentioning

confidence: 99%

Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities

Taninokuchi Tomassoni,

Braccischi,

Russo

et al. 2024

Diagnostics

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Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients’ quality of life, and reducing the economic burden.

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“…100 Another important issue is the high technical failure rate for IA injections which ranges between 29% and 38% per joint, and 46% and 64% per procedure. 58,101 In addition to corticosteroids, lumbar facet joint injection using autologous platelet-rich plasma, 102 hyaluronic acid, 103 and medical ozone 104 have yielded mixed results based on low-quality studies, and are currently not recommended outside of clinical studies. 5,105 Other treatments for lumbar facet joint pain such as fluoroscopy-guided high-intensity focused ultrasound and percutaneous fixation techniques are also devoid of high-quality data and are not recommended at this time.…”

Section: Intra-articular Injectionsmentioning

confidence: 99%

3. Pain originating from the lumbar facet joints

Van den Heuvel,

Cohen,

de Andrès Ares

et al. 2023

Pain Practice

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IntroductionPain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well‐designed studies, the prevalence is generally between 10% and 20%, increasing with age.MethodsThe literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized.ResultsThere are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni‐ or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non‐dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After “red flags” are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation.ConclusionsWell‐selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.

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Medical ozone therapy in facet joint syndrome: an overview of sonoanatomy, ultrasound-guided injection techniques and potential mechanism of action

Cited by 7 publications

References 54 publications

Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review

Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review

Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities

3. Pain originating from the lumbar facet joints

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