Ozone treatment for back pain
Keywords: low back pain, oxygen-ozone therapy, minimally invasive technique
Aims: “Intramuscular paravertebral injections of ozone are minimally invasive, safe and efficacy in reducing pain and disability. The aim of this paper is to present the early results of paravertebral lumbar ozone injections in the treatment of low back pain.”(1)
Methods: “Between February 2011 and December 2015, a total of 109 patients underwent intramuscular paravertebral lumbar injections of ozone due to low back pain. Of them, 42 interrupted the treatment at a medium of 5.4 injections and were lost to follow-up. Of the 67 remaining patients, only 24 answered to our questionnaire. Local and radiating pain was assessed using a 10-cm horizontal Visual Analogue Scale. Perceived functional status and disability were evaluated using the Oswestry Disability Index, administered before treatment and one month after the last injection.”(1)
Results: “Visual Analogue Scale reduction was demonstrated in 23 out of 29 cycles (79%) of ozone therapy. Regarding disability evaluation, Oswestry Disability Index score reduction was assessed in all except one. No complications were recorded. Our results are similar to the other reports: 79% of patients had VAS reduction of 2.3 points and all except one patient reported ODI reduction (average reduction of 9%).” (1)
Conclusions: “Lumbar paravertebral oxygen-ozone injections are minimally invasive, safe, cheaper and effective in relieving pain as well as disability. This technique is easy to perform, it doesn’t need computed-tomography or anesthesiologist support. We suggest its application in low back pain as first choice to replace intradiscal computed-tomography-guided infiltrations and to avoid or delay surgery.” (1)
“Between February 2011 and December 2015, a total of 109 patients underwent intramuscular paravertebral lumbar injections of ozone due to LBP. Of them, 42 interrupted the treatment at a medium of 5.4 injections and were lost to follow-up. Seventeen of them had a reduced VAS, 14 had an increased VAS and 11 were stable. Finally, a total of 67 patients completed the 12 injections of ozone and were followed before and after treatment. All patients were studied with clinical evaluation, standard x-rays and Magnetic Resonance Imaging (MRI). All patients had a long clinical history, with an average of 6.5 years of LBP (range 1-20 years). Four of them underwent lumbar herniectomy before our treatment. LBP was due in 10 patients to lumbar discal bulging (LDB). Seven cases had LDB associated with sciatica without neurological deficits. Four patients had lumbar DH, 2 had lumbar stenosis and 1 had spondylolisthesis. Five of them underwent 2 cycles of injections.”
“All patients were retrospectively evaluated with VAS and ODI scale. The mean pre-treatment VAS score was 5.6 (range 0-10), while the mean pre-treatment ODI score was 34% (range 12-62%). After treatment, we obtained a reduction of 2.3 point of the VAS scale (mean value was 3.3) and of 9% of the ODI score (mean value 25%). Three patients underwent lumbar videoscopy after treatment, because of persistent LBP, of which 1 was a 79 year-old man with severe lumbar stenosis, 1 was a 65 year-old female with spondylolisthesis L5-S1 and the last was a 64 year-old man with multiple DH.
VAS reduction was demonstrated in 23 out of 29 cycles (79%) of ozone therapy (mean VAS score reduction 2.3); 6 of them had a VAS score increase (mean VAS score increase 2.5).
Regarding disability evaluation, ODI score reduction was assessed in all except one patient (a 79 year-old man with severe lumbar stenosis). No complications were recorded.” (1)
“Lumbar paravertebral oxygen-ozone injections in the treatment of LBP are minimally invasive, safe, cheaper and effective in relieving pain as well as disability. In literature only a very small percentage of patients are reported to present side effects. This technique is easy to perform, it doesn’t need CT or anesthesiologist support. We suggest its application in LBP (due to lumbar discal bulging, lumbar stenosis, spondylolisthesis and DH) as first choice to replace intradiscal CT-guided infiltrations and to avoid or delay surgery.” (1)