Therapeutic Effect of Medical Ozone on Lumbar Disc Herniation

Abstract

BackgroundThis study aimed to investigate the therapeutic effect of low, medium, and high concentrations of medical ozone on trauma-induced lumbar disc herniation.Material/MethodsA total of 80 patients were included and were grouped into a control group, a low medical ozone (20 μg/ml) group, a medium medical ozone (40 μg/ml) group, and a high medical ozone (60 μg/ml) group. The CT scan and enzyme-linked immunosorbent assay (ELISA) were used to detect IL-6 level, SOD activity, IgM, and IgG levels upon admission and at 6 and 12 months after follow-up. The area under the ROC curve (AUC) was calculated for visual analogue scale (VAS) and efficiency rate.ResultsAll patients showed disc retraction at 6- and 12-month follow-up; while patients in the medium medical ozone (40 μg/ml) group showed the greatest disc retraction rate. The IL-6, IgM, IgG, and VAS levels significantly decreased while SOD activity increased among all groups over time (p<0.05). The AUCIL-6, AUCIgG, AUCIgM, and AUCSOD was closest to 1 in the medium medical ozone (40 μg/ml) group compared with other groups (p<0.01), with the highest efficacy at 6 (35%) and 12 (85%) months during follow-up.ConclusionsLow concentrations of medical ozone (20 μg/ml and 40 μg/ml) reduced the serum IL-6, IgG, and IgM expression, presenting as analgesic and anti-inflammatory effects, while high concentrations of medical ozone (60 μg/ml) increased the serum IL-6, IgG, IgM expression, presenting as pain and pro-inflammatory effects.The medical ozone concentration of 40 μg/ml showed the optimal treatment efficacy.

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

“…1 In a randomized trial conducted by Niu et al investigating the therapeutic effect of low, medium and high concentrations of medical ozone on patients with trauma-induced lumbar disc herniation, the group receiving a medium volume of medical ozone (40 mg/ml) showed the greatest disc retraction rate. 7 Muto et al conducted oxygen-ozone chemonucleolysis procedures in 2900 patients with lumbar disc herniation and reported success rates of 75-80% for soft disc herniation, 70% for multiple disc herniation and 55% for failed back surgery syndrome. 8 Paoloni et al in a multicenter randomized, double-blind, therapy-controlled trial among patients with acute low back pain due to lumbar disc herniation found that patients who received ozone therapy had significantly lower mean pain scores than patients who received simulated therapy throughout the observation period.…”

“…investigating the therapeutic effect of low, medium and high concentrations of medical ozone on patients with trauma-induced lumbar disc herniation, the group receiving a medium volume of medical ozone (40 µg/ml) showed the greatest disc retraction rate. 7 Muto et al. conducted oxygen-ozone chemonucleolysis procedures in 2900 patients with lumbar disc herniation and reported success rates of 75–80% for soft disc herniation, 70% for multiple disc herniation and 55% for failed back surgery syndrome.…”

Expert consensus of Chinese Association for the Study of Pain on the application of ozone therapy in pain medicine

“…The concentration for ozone ablation in the treatment of herniated lumbar intervertebral disc is usually 40 μg/mL[ 46 , 47 ]. The capacity of each lumbar spine disc is 4-5 mL[ 46 ], and the capacity of each cervical spine disc is 2-3 mL. The injection rate should be slow, and the patient’s response should be observed throughout.…”

Clinical Uses and Molecular Aspects of Ozone Therapy: A Review

“…In local injection, such as intradiscal injection, used mainly for back pain such as disc herniation, an average of 50 µg/mL of ozone is usually injected into an ozone/oxygen mixture (Niu et al, 2018). Also, there are intrapatellar ozone injection protocols at an average concentration of 15 µg/mL that is effective in treating osteoarthritis (Babaei-Ghazani et al, 2018).…”