Kharrat Abdelkader, Elmounedi Najah, Tmar Mohamed Ali, Bahloul Walid, Guidara Ahmed Racem, Lajmi Achraf, Sahnoun Nizar, Trigui Moez, Ellouz Zoubaier, Keskes Hassib
Rheumatologist Private Practitioner in Sfax, Sfax, Tunisia.
Cell Therapy and Experimental Surgery of Musculoskeletal System LR18SP11 Lab, Medicine Faculty of Sfax, University of Sfax, Majida Boulila Road, 3029, Sfax, Tunisia.
Clin Rheumatol. 2025 Jan;44(1):475-485. doi: 10.1007/s10067-024-07255-1. Epub 2024 Dec 4.
Ozone (O-O) nucleolysis is emerging as a promising minimally invasive therapy for treating lumbosciatica due to herniated discs. This study aims to evaluate changes in pain and functional abilities before and after ozone disc nucleolysis in patients with lumbar disc herniation (LDH).
This study included 34 patients (15 males, 19 females; age range 17-76, average age 46.7 ± 11.2 years) treated between April 2018 and May 2022. A single dose of an O-O mixture (5 ml, 30 µg/ml) was injected into the disc under fluoroscopic guidance via a lateral approach, followed by an additional periradicular injection of the same mixture (5 ml) combined with a corticosteroid (2 ml). Pain and patient satisfaction were assessed using the VAS score and modified MacNab criteria, while MRI findings evaluated treatment-related changes, including herniated disc surface and disc height.
VAS scores indicated pain improvement in 85% of patients, with 82% achieving satisfactory outcomes per modified MacNab criteria. Patients under 50 years of age showed greater responsiveness to ozone therapy. Central LDH responded more favorably than larger foraminal herniations, and hernias with a larger surface area than the average also showed better outcomes. No complications were observed.
Ozone therapy is a cost-effective, simple, and safe minimally invasive technique that provides significant pain relief and functional improvement. It may be a reliable and competitive treatment option for patients with persistent symptoms after conservative treatment and before considering surgical intervention. Key Points •Ozone nucleolysis provides a minimally invasive treatment for lumbosciatica with reduced recovery time. •Injecting oxygen-ozone into the disc decreases its volume and inflammation, easing nerve pressure. •Initial results show significant pain relief and improved mobility in patients following treatment. •This method appears safe, with fewer complications than traditional surgery for herniated discs.
臭氧（O₃）髓核溶解术正成为一种有前景的治疗椎间盘突出症所致腰腿痛的微创疗法。本研究旨在评估腰椎间盘突出症（LDH）患者臭氧椎间盘髓核溶解术前、后的疼痛及功能能力变化。
本研究纳入了2018年4月至2022年5月期间治疗的34例患者（男性15例，女性19例；年龄范围17 - 76岁，平均年龄46.7±11.2岁）。在透视引导下经外侧入路将单剂量的臭氧混合气体（5 ml，30 μg/ml）注入椎间盘，随后在神经根周围额外注射相同混合气体（5 ml）并联合皮质类固醇（2 ml）。采用视觉模拟评分（VAS）和改良MacNab标准评估疼痛及患者满意度，同时通过磁共振成像（MRI）结果评估与治疗相关的变化，包括椎间盘突出表面及椎间盘高度。
VAS评分显示85%的患者疼痛得到改善，根据改良MacNab标准，82%的患者获得满意结果。50岁以下患者对臭氧治疗反应更佳。中央型LDH的反应比较大的椎间孔型疝更有利，且表面积大于平均水平的疝也显示出更好的结果。未观察到并发症。
臭氧治疗是一种经济有效、简单且安全的微创技术，能显著缓解疼痛并改善功能。对于保守治疗后仍有持续症状且在考虑手术干预之前的患者，它可能是一种可靠且有竞争力的治疗选择。要点：•臭氧髓核溶解术为腰腿痛提供了一种微创治疗方法，恢复时间缩短。•向椎间盘内注射氧 - 臭氧可减小其体积并减轻炎症，缓解神经压迫。•初步结果显示治疗后患者疼痛明显减轻且活动能力改善。•该方法似乎安全，与传统椎间盘突出症手术相比并发症更少。
