Percutaneous Pulsed Radiofrequency versus Combined Intradiscal Oxygen-Ozone Therapy with Percutaneous Radiofrequency for Management of Discogenic Cervical Radiculopathy

Abstract

BACKGROUND: Cervical radiculopathy can lead to severe disability. Non-invasive treatment can be the primary option in many circumstances. Minimally invasive therapies were developed to provide good clinical results while also being a low-cost technique that is well tolerated. These methods have gained popularity in recent years as it avoids severe soft-tissue injury, extensive hospitalization, and a lengthy recovery period. Radiofrequency (RF) is classified into continuous radiofrequency, which uses thermocoagulation, and pulsed radiofrequency (PRF), which uses an electromagnetic field. OBJECTIVE:The aim of this study was to compare between PRF at the cervical root combined with intradiscal ozone injection and PRF alone for treatment of patients with discogenic cervical radiculopathy. PATIENTS AND METHODS:The present study was carried out at Neurosurgery department, Alexandria University on 60 patients with cervical radiculopathy in a randomized controlled clinical trial. Patients were randomly allocated by a computer based program into three groups (20 patients each). In group I patients had PRF combined with intradiscal oxygen-ozone, in group II patients had PRF alone, and in group III, the control group, patients received only diagnostic blocks. RESULTS:Our study showed that PRF combined with intradiscal ozone and pulsed RF alone had good clinical outcome when comparing it to control group in terms of reduction of pain, need of medications, neck disability index and need for surgery. There was significant shrinkage of herniated disc fragment in magnetic resonance imaging (MRI) done 3 months after intervention in 5 patients in Group I. CONCLUSION:Combining pulsed RF with intradiscal ozone provides good clinical and radiological outcome in patients with cervical disc herniation and can be tried before open discectomy for patients with cervical disc herniation.

A Case Report on Pneumocephalus That Occurred Following an Epidural Ozone Injection During Percutaneous Lumbar Disc Decompression Surgery

“…This therapy involves the use of a specialized machine that combines ozone with oxygen at a predetermined concentration. The mixture was then administered via a polypropylene syringe for a procedure known as discolysis, which is a non-surgical approach for managing disc prolapse (24). Ozone therapy has been observed to be generally safe, with a low rate of procedural complications, estimated to be around 0.1%.…”