Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
La radiologia medica
Published in: La radiologia medica 6/2016

01-06-2016 | COMPUTED TOMOGRAPHY

Indications and efficacy of O2–O3 intradiscal versus steroid intraforaminal injection in different types of disco vertebral pathologies: a prospective randomized double-blind trial with 517 patients

Authors: Marco Perri, Claudia Marsecano, Marco Varrassi, Aldo Victor Giordano, Alessandra Splendiani, Ernesto di Cesare, Carlo Masciocchi, Massimo Gallucci

Published in: La radiologia medica | Issue 6/2016

Login to get access

Abstract

Objective

The aim of this study was to prospectively evaluate the clinical efficacy of perigangliar steroid and local anesthetic with intradiscal O2–O3 injection versus steroid and local anesthetic intraforaminal injection in different types of herniation and grade of disc degeneration.

Materials and methods

A total of 517 patients were randomly assigned to two groups. Control Group (159 men, 101 women; age range 25–89 years) underwent steroid and local anesthetic intraforaminal injection. Study Group (163 men, 94 women; age range 22–92 years) underwent the same treatment with addiction of O2–O3 intradiscal injection. Procedures were performed under computed tomographic guidance. Visual Analog Scale Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Results were compared with Kruskal–Wallis and t test.

Results

After 6 months, O2–O3 discolysis was successful in 106 (41.24 %) Study Group patients with extrusions compared with 9 Control Group patients (3.5 %) (P < 0.001). In 89 (34.6 %) Study Group patients with protrusions, success rate was statistically significant compared with 5 Control Group patients (1.9 %). Significant difference was detected in the presence of Grade I, II, III of Degenerated Disc in 185 of Study Group patients (68.4 %) compared with 4 Control Group patients (1.5 %).

Conclusions

The addition of O2–O3 discolysis is more effective at 6 months than perigangliar steroid and local anesthetic injection, especially in cases of herniated or protruded discs and with a Grade of Disc Degeneration from mild to moderate range.
Literature
1.
Andersson GBJ (1997) The epidemiology of spinal disorders. In: Frymoyer JW (ed) The adult spine: principles and practice, 2nd edn. Lippincott-Raven, Philadelphia, pp 93–141
2.
3.
4.
Deyo RA, Rainville J, Kent DL (1992) What can the history and physical examination tell us about low back pain? JAMA 268:760–765CrossRefPubMed
5.
Bozzao A, Gallucci M, Masciocchi C, Aprile L, Barile A, Passariello R (1992) Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology 185:135–141CrossRefPubMed
6.
Iliakis E, Valadakis V, Vynios DH, Tisiganos CP, Agapitos E (2001) Rationalization of the activity of medical ozone on intervertebral disc: a histological and biochemical study. Riv Neuroradiol 14:23–30CrossRef
7.
Guarnieri G, Vassallo P, Pezzullo MG et al (2009) A Comparison of minimally invasive techniques in percutaneous treatment of lumbar herniated discs. Neuroradiol J 22:108–121CrossRefPubMed
8.
Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M (2003) Minimally invasive oxygen–ozone therapy for lumbar disk herniation. Am J Neuroradiol 24:996–1000PubMed
9.
Muto M, Andreula CF, Leonardi M (2004) Treatment of herniated lumbar disc by intradiscal and intraforaminal oxygen–ozone(O2–O3) injection. J Neuroradiol 31:183–189CrossRefPubMed
10.
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 242:907–913CrossRefPubMed
11.
Perri M, Grattacaso G, Di Tunno V et al (2015) MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2–O3 discolysis. Neuroradiol J 13:1971400915576658
12.
Perri M, Grattacaso G, Di Tunno V et al (2015) T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen–ozone discolysis: a randomized, double-blind trial with steroid and O2–O3 discolysis versus steroid only. Radiol Med 6
13.
Splendiani A, Perri M, Conchiglia A et al (2013) MR assessment of lumbar disk herniation treated with oxygen–ozone diskolysis: the role of DWI and related ADC versus intervertebral disk volumetric analysis for detecting treatment response. Neuroradiol J 26:347–356CrossRefPubMed
14.
Lee JS, Hobden E, Stiell IG, Wells GA (2003) Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med 10:1128–1130CrossRefPubMed
15.
Fardon DF, Milette PC (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the combined task forces of the north american spine society, American society of spine radiology, and american society of neuroradiology. Spine 26:93–113CrossRef
16.
Pfirrmann CWA, Dora C, Schmid MR, Zanetti M, Hodler J, Boos N (2004) MR image–based grading of lumbar nerve root compromise due to disk herniation: reliability study with surgical correlation. Radiology 230:583–588CrossRefPubMed
17.
Landis RJ, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(159–74):15
18.
Richelmi P, Valdenassi L, Bertè F (2001) Basi farmacologiche dell’azione dell’ossigenoozono terapia. Riv Neuroradiol 14:17–22CrossRef
19.
D’Erme M, Scarchilli A, Artale AM, Pasquali Lasagni M (1998) Ozonetherapy in lumbar sciatic pain [in Italian]. Radiol Med (Torino) 95:21–24
20.
Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M (2003) Minimally invasive oxygen–ozone therapy for lumbar disk herniation. AJNR Am J Neuroradiol 24:996–1000PubMed
21.
Muto M, Avella F (1998) Percutaneous treatment of herniated lumbardisc by intradiscal oxygen–ozone injection. Intervent Neuroradiol 4:279–286
22.
Paradiso R, Alexandre A (2005) The different outcomes of patients with disc herniation treated either by microdiscectomy, or by intradiscal ozone injection. Acta Neurochir Suppl 92:139–142CrossRefPubMed
23.
Leonardi M, Simonetti L, Barbara C (2001) Effetti dell’ozono sul nucleo polposo: reperti anatomo-patologici su un caso operato. Riv Neuroradiol 14:57–59CrossRef
24.
Bocci V, Luzzi E, Corradeschi F, Fanetti G (1993) Studies on the biological effects of ozone: III, an attempt to define conditions for optimal induction of cytokines. Lymphokine Cytokine Res 12:121–126PubMed
25.
Simonetti L, Agati R, Cenni P, de Santis F, Leonardi M (2001) Mechanism of pain in disc disease. Riv Neuroradiol 14:171–174CrossRef
26.
Siddal PJ, Cousins MJ (1997) Spine update spinal pain mechanism. Spine 22:98–104CrossRef
27.
Bonetti M, Fontana A, Cotticelli B, Volta GD, Guindani M, Leonardi M (2005) Intraforaminal O2–O3 versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR Am J Neuroradiol 26:996–1000PubMed
28.
Gallucci M, Bozzao A, Orlandi B, Manetta R, Brughitta G, Lupattelli L (1995) Does postcontrast MR enhancement in lumbar disk herniation have prognostic value? J Comput Assist Tomogr 19:34–38CrossRefPubMed
29.
Splendiani A, Puglielli E, De Amicis R, Barile A, Masciocchi C, Gallucci M (2004) Spontaneous resolution of lumbar disk herniation: predictive signs for prognostic evaluation. Neuroradiology 46:916–922CrossRefPubMed
30.
Paradiso R, Alexandre A (2005) The different outcomes of patients with disc herniation treated either by microdiscectomy, or by intradiscal ozone injection. Acta Neurochir 92:139–142CrossRef
Metadata
Title
Indications and efficacy of O2–O3 intradiscal versus steroid intraforaminal injection in different types of disco vertebral pathologies: a prospective randomized double-blind trial with 517 patients
Authors
Marco Perri
Claudia Marsecano
Marco Varrassi
Aldo Victor Giordano
Alessandra Splendiani
Ernesto di Cesare
Carlo Masciocchi
Massimo Gallucci
Publication date
01-06-2016
Publisher
Springer Milan
Published in
La radiologia medica / Issue 6/2016
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-015-0598-x

Other articles of this Issue 6/2016

La radiologia medica 6/2016 Go to the issue

CONTRAST MEDIA

Gadolinium-based contrast agents: did we miss something in the last 25 years?

RADIOTHERAPY

Management of radiation therapy patients with cardiac defibrillator or pacemaker

ULTRASONOGRAPHY

The utility of the high-resolution ultrasound technique in the evaluation of autologous adipose tissue lipofilling, used for the correction of post-surgical, post-traumatic and post-burn scars

HEAD, NECK AND DENTAL RADIOLOGY

Combined multimodal co-registration of PET/CT and MRI images increases diagnostic accuracy in squamous cell carcinoma staging

COMPUTED TOMOGRAPHY

Added value of lung window in detecting drug mules on non-contrast abdominal computed tomography

VASCULAR AND INTERVENTIONAL RADIOLOGY

Are abdominal aortic aneurysms with hostile neck really unsuitable for EVAR? Our experience