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Intradiscal ozone therapy: fluoroscopic guidance reduces operative time in comparison with CT guidance in patients with lumbar disc herniation

  • Neuroradiology
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Abstract

Purpose

To compare clinical success and operative time for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation using fluoroscopic guidance versus computed tomography (CT).

Materials and Methods

During the year 2019, 68 percutaneous single-level intradiscal ozone therapies were performed on patients complaining of low back pain and/or sciatica due to lumbar disc herniation, using fluoroscopic or conventional CT guidance, respectively, in 35 and 32 herniated lumbar discs, with at least 1-month follow-up. Oswestry Disability Index (ODI) was used to assess clinical outcome. Total room utilization time and procedure operative time were recorded for both fluoroscopy and CT guidance.

Results

Fluoroscopy and CT groups were similar in terms of patient age (p value 0.45) and pre-procedure ODI (p value 0.64). Clinical success was obtained in 87.50% (28/32) patients in fluoroscopic group and 83.33% (30/36) in CT group. Mean total room utilization time was significantly longer for CT guidance (31.38 vs. 50.67 min, p < 0.0001), as well as the procedure operative time (15.94 vs. 27.61 min, p < 0.0001).

Conclusions

Compared to conventional CT guidance, fluoroscopic guidance for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation shows similar clinical success rates at 1-month follow-up, with decreased room utilization time and procedure operative time that implies less time consumption for medical and paramedical operative team.

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References

  1. Freynhagen R, Baron R, Gockel U, Tölle TR (2006) painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 10:1911–20. https://doi.org/10.1185/030079906X132488

    Article  Google Scholar 

  2. Kaki AM, El-Yaski AZ, Youseif E (2005) Identifying neuropathic pain among patients with chronic low-back pain: use of the leeds assessment of neuropathic symptoms and signs pain scale. Reg Anesth Pain Med. 30(5):422–8. https://doi.org/10.1016/j.rapm.2005.05.013

    Article  PubMed  Google Scholar 

  3. Murphy K, Muto M, Steppan J, Meaders T, Boxley C (2015) Treatment of contained herniated lumbar discs with ozone and corticosteroid: a pilot clinical study. Can AssocRadiol J. 66(4):377–84. https://doi.org/10.1016/j.carj.2015.01.003

    Article  Google Scholar 

  4. Miyoshi S, Sekiguchi M, Konno S, Kikuchi S, Kanaya F (2011) Increased expression of vascular endothelial growth factor protein in dorsal root ganglion exposed to nucleus pulposus on the nerve root in rats. Spine. J 36(1):E1-6

    Article  Google Scholar 

  5. McCarron RF, Wimpee MW, Hudkins PG, Laros GS (1987) The inflammatory effect of nucleus pulposus. a possible element in the pathogenesis of low-back pain. Spine 12:760–764

    Article  CAS  Google Scholar 

  6. Rhee JM, Schaufele M, Abdu WA (2006) Radiculopathy and the herniated lumbar disc: controversies regarding pathophysiology and management. JBJS 88(9):2069–2080

    Article  Google Scholar 

  7. Jones KL, Bryan TW, Jinkins PA et al (1998) Superoxide released from neutrophils causes reduction in nitric oxide gas. Am J Physiol 279:1120–1126

    Google Scholar 

  8. Gibson JNA, Waddell G (2009) Surgical interventions for lumbar disc prolapse. Cochrane Database Syst Rev 1:CD001350

    Google Scholar 

  9. Manchikanti L, Falco FJ, Benyamin RM et al (2013) An update of the systematic assessment of mechanical lumbar disc decompression with nucleoplasty. Pain Physician. 16:SE25-54

    Article  Google Scholar 

  10. Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    CAS  PubMed  Google Scholar 

  11. Ostelo RW, Deyo RA, Stratford P et al (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33(1):90–4. https://doi.org/10.1097/BRS.0b013e31815e3a10

    Article  Google Scholar 

  12. Gallucci M, Limbucci N, Zugaro L et al (2007) Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only. Radiology 242:907–913

    Article  Google Scholar 

  13. Andreula C, Muto M, Leonardi M (2004) Interventional spinal procedures. Eur J Radiol 50:112–119

    Article  Google Scholar 

  14. Steppan J, Meaders T, Muto M, Murphy KJ (2010) A metaanalysis of the effectiveness and safety of ozone treatments for herniated lumbar discs. J Vasc Interv Radiol. 21(4):534–48. https://doi.org/10.1016/j.jvir.2009.12.393

    Article  PubMed  Google Scholar 

  15. Pellicano G, Martinelli F, Tavanti V et al (2007) (2007) The Italian oxygen-ozone therapy federation (FIO) study on oxygen-ozone treatment of herniated disc. Int J Ozone Ther 6:7–15

    Google Scholar 

  16. Ezeldin M, Leonardi M, Princiotta C et al (2018) Percutaneous ozone nucleolysis for lumbar disc herniation. Neuroradiology. 60(11):1231–1241. https://doi.org/10.1007/s00234-018-2083-4

    Article  PubMed  PubMed Central  Google Scholar 

  17. Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M (2003) Minimally invasive oxygen-ozonetherapy for lumbar disk herniation. Am J Neuroradiol 24(5):996–1000

    PubMed  PubMed Central  Google Scholar 

  18. Muto M, Ambrosanio G, Guarnieri G, Capobianco E, Piccolo G, Annunziata G, Rotondo A (2008) Low back pain and sciatica: treatment with intradiscal-intraforaminal O(2)-O (3) injection. Our experience. Radiol Med. 113(5):695–706. https://doi.org/10.1007/s11547-008-0302-5

    Article  CAS  PubMed  Google Scholar 

  19. Oder B, Loewe M, Reisegger M, Lang W, Ilias W, Thurnher SA (2008) CT guided ozone/steroid therapy for the treatment of degenerative spinal disease: effect of age, gender, disc pathology and multi-segmental changes. Neuroradiology. 50:777e85

    Article  Google Scholar 

  20. Lu W, Li YH, He XF (2010) Treatment of large lumbar disc herniation with percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint. World J Radiol. 2(3):109–12. https://doi.org/10.4329/wjr.v2.i3.109

    Article  PubMed  PubMed Central  Google Scholar 

  21. Buy X, Gangi A (2010) Percutaneous treatment of intervertebral disc herniation. Semin Intervent Radiol. 27(2):148–59. https://doi.org/10.1055/s-0030-1253513

    Article  PubMed  PubMed Central  Google Scholar 

  22. Filippiadis DK, Kelekis A (2016) A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies. Br J Radiol. 89(1057):20150357. https://doi.org/10.1259/bjr.20150357

    Article  PubMed  Google Scholar 

  23. Kelekis AD, Filippiadis DK, Martin JB, Brountzos E (2010) Standards of practice: quality assurance guidelines for percutaneous treatments of intervertebral discs. Cardiovasc Intervent Radiol. 33(5):909–13. https://doi.org/10.1007/s00270-010-9952-5

    Article  PubMed  Google Scholar 

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Funding

No funding has been recieved for this research.

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Authors and Affiliations

  1. UOC Neuroradiologia, Ospedale del Mare, ASL NA 1 Centro, Via Enrico Russo, 80147, Napoli, Italy

    Francesco Somma, Alberto Negro, Gianvito Pace, Giuseppe Maria Ernesto La Tessa & Vincenzo d’Agostino

  2. Dipartimento Medicina di Precisione, Università Vanvitelli, Via de Crecchio, 80138, Napoli, Italy

    Gianluca Gatta & Ferdinando Caranci

  3. Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, 80131, Napoli, Italy

    Mario Tortora

  4. UOC Radiologia, Ospedale Monaldi, AO dei Colli, Via Leonardo Bianchi, 80131, Napoli, Italy

    Gaetano Rea

  5. UOC Radiologia, Ospedale del Mare, ASL NA 1 Centro, Via Enrico Russo, 80147, Napoli, Italy

    Stefania Tamburrini

Authors
  1. Francesco Somma
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  2. Gianluca Gatta
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  3. Alberto Negro
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  4. Mario Tortora
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  5. Gaetano Rea
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  6. Stefania Tamburrini
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  7. Gianvito Pace
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  8. Giuseppe Maria Ernesto La Tessa
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  9. Ferdinando Caranci
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  10. Vincenzo d’Agostino
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Correspondence to Francesco Somma.

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Somma, F., Gatta, G., Negro, A. et al. Intradiscal ozone therapy: fluoroscopic guidance reduces operative time in comparison with CT guidance in patients with lumbar disc herniation. Radiol med 127, 526–533 (2022). https://doi.org/10.1007/s11547-022-01469-6

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  • DOI: https://doi.org/10.1007/s11547-022-01469-6

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