Department of Orthopaedic and Traumatology, Baskent University Hospital, Ankara, Turkey.
Department of Neurosurgery, Baskent University Hospital, Ankara, Turkey.
World Neurosurg. 2023 Jul;175:e296-e302. doi: 10.1016/j.wneu.2023.03.075. Epub 2023 Mar 23.
To demonstrate the effect of medical ozone therapy on the development of epidural fibrosis.
A total of 25 Sprague-Dawley male rats were randomly divided into 3 groups: a control group (L3-L4 laminectomy only), a systemic ozone therapy (SOT) group (L3-L4 laminectomy only + intraperitoneal 15 mL [30 μg/mL] ozone), and a local ozone therapy (LOT) group (L3-L4 laminectomy only + subcutaneous 15 mL [30 μg/mL] ozone). Ozone therapy was administered 4 times on a 3-day interval during the wound-healing process, with the first dose immediately administered after surgery. The effects of ozone therapy on vascular endothelial growth factor, inflammation, and epidural fibrosis between groups were evaluated.
Staining with vascular endothelial growth factor was significantly less in the group that received SOT compared with the control group (P = 0.021). When the groups were compared in terms of inflammation, it was found that inflammation was less common in the SOT and LOT groups compared with the control group (SOT vs. control: P = 0.004 and LOT vs. control: P = 0.024), whereas inflammation was found to be significantly less in the SOT group compared with the LOT group (P = 0.008). In the histopathologic evaluation of epidural fibrosis, there was no significant difference between the SOT and LOT groups but less epidural fibrosis was observed in both groups compared to the control group (LOT vs. control: P = 0.037; SOT vs. control: P = 0.018).
Medical ozone therapy may be an alternative method that can be used effectively and safely in the prevention of epidural fibrosis after laminectomy.
展示医用臭氧治疗对硬膜外纤维化发展的影响。
将 25 只雄性 Sprague-Dawley 大鼠随机分为 3 组：对照组（仅行 L3-L4 椎板切除术）、全身臭氧治疗组（仅行 L3-L4 椎板切除术+腹腔内 15 mL [30 μg/mL] 臭氧）和局部臭氧治疗组（仅行 L3-L4 椎板切除术+皮下 15 mL [30 μg/mL] 臭氧）。在伤口愈合过程中，每隔 3 天进行 4 次臭氧治疗，第一次治疗在手术后立即进行。评估臭氧治疗对各组血管内皮生长因子、炎症和硬膜外纤维化的影响。
与对照组相比，SOT 组的血管内皮生长因子染色明显减少（P=0.021）。在炎症方面，与对照组相比，SOT 和 LOT 组的炎症发生率较低（SOT 与对照组：P=0.004；LOT 与对照组：P=0.024），而 SOT 组的炎症发生率明显低于 LOT 组（P=0.008）。在硬膜外纤维化的组织病理学评估中，SOT 和 LOT 组之间没有显著差异，但与对照组相比，两组的硬膜外纤维化程度均较低（LOT 与对照组：P=0.037；SOT 与对照组：P=0.018）。
医用臭氧治疗可能是一种有效且安全的预防椎板切除术后硬膜外纤维化的替代方法。
