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PT  - JOURNAL ARTICLE
AU  - Andreula, Cosma F.
AU  - Simonetti, Luigi
AU  - de Santis, Fabio
AU  - Agati, Raffaele
AU  - Ricci, Renata
AU  - Leonardi, Marco
TI  - Minimally Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation
DP  - 2003 May 01
TA  - American Journal of Neuroradiology
PG  - 996--1000
VI  - 24
IP  - 5
4099  - http://www.ajnr.org/content/24/5/996.short
4100  - http://www.ajnr.org/content/24/5/996.full
SO  - Am. J. Neuroradiol.2003 May 01; 24
AB  - BACKGROUND AND PURPOSE: Oxygen-ozone therapy is a minimally invasive treatment for lumbar disk herniation that exploits the biochemical properties of a gas mixture of oxygen and ozone. We assessed the therapeutic outcome of oxygen-ozone therapy and compared the outcome of administering medical ozone alone with the outcome of medical ozone followed by injection of a corticosteroid and an anesthetic at the same session.METHODS: Six hundred patients were treated with a single session of oxygen-ozone therapy. All presented with clinical signs of lumbar disk nerve root compression, with CT and/or MR evidence of contained disk herniation. Three hundred patients (group A) received an intradiscal (4 mL) and periganglionic (8 mL) injection of an oxygen-ozone mixture at an ozone concentration of 27 μg/mL. The other 300 patients (group B) received, in addition, a periganglionic injection of corticosteroid and anesthetic. Therapeutic outcome was assessed 6 months after treatment by using a modified MacNab method. Results were evaluated by two observers blinded to patient distribution within the two groups.RESULTS: A satisfactory therapeutic outcome was obtained in both groups. In group A, treatment was a success (excellent or good outcome) in 70.3% and deemed a failure (poor outcome or recourse to surgery) in the remaining 29.7%. In group B, treatment was a success in 78.3% and deemed a failure in the remaining 21.7%. The difference in outcome between the two groups was statistically significant (P &amp;lt; .05).CONCLUSION: Combined intradiscal and periganglionic injection of medical ozone and periganglionic injection of steroids has a cumulative effect that enhances the overall outcome of treatment for pain caused by disk herniation. Oxygen-ozone therapy is a useful treatment for lumbar disk herniation that has failed to respond to conservative management.