Abstract

CASTRO, M. et al. Percutaneous ozone discolysis: our experience. Rev. Soc. Esp. Dolor [online]. 2009, vol.16, n.7, pp.405-409. ISSN 1134-8046.

Objective: To demonstrate the safety and effectiveness of percutaneous discolysis using ozone in the treatment of symptomatic lumbar hernia. Material and methods: We performed a prospective observational study in 41 patients diagnosed with symptomatic lumbar hernia, in whom we performed 49 percutaneous discolysis procedures introducing ozone in the lumbar region between February 2004 and February 2009. All the procedures were performed in the operating room under radiological guidance, with aseptic conditions, local anaesthesia and sedation. The ozone was introduced into the lumbar disc (5 to 7 ml), in the epidural (5 to 7 ml) and periradicular spaces (5 to 7 ml) at a concentration of 27 Ìg. In all patients, 1500 mg of cefuroxime was administrated intravenously as a prophylactic measure. The effectiveness of the treatment was based on pain control according to the visual analogue scale before the procedure (VAS 0), at 30 days (VAS 1), at 90 days (VAS 3) and at 6 months (VAS 6), and by means of Lattinen's test before treatment and at the end of the study. All the patients were asked about the possible adverse effects of the treatment and a survey was carried out on patient satisfaction with the technique. Results: We performed 49 percutaneous ozone discolysis procedures in 41 patients. The initial mean VAS was 7.37 ± 0.96 and subsequent values were 2.41 ± 2.17 at 1 month, 1.80 ± 2.31 at 3 months and 2.05 ± 2.45 at 6 months, with statically significant differences in the three measurements. The initial mean Lattingen index was 12.68 ± 2.32 and was 6.07 ± 2.91 at 6 months, representing a statically significant reduction. Adverse effects occurred in only five patients (12.2%): four mild transient headaches and one symptomatic pneumoencephalos, requiring bed rest for 1 week until spontaneous reabsorption. The degree of satisfaction was good in 35 patients (85.4%), acceptable in four (9.8%) and bad in only two patients (4.9%). Conclusions: Percutaneous ozone discolysis is a safe and effective technique in the treatment of symptomatic lumbar hernia.

Keywords : Percutaneous dyscolisis; Ozone; Disk herniation.

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