Ozone is an emerging method of treating back pain which has been unresponsive to conventional back pain injections. Medical manufactured ozone (O3) is safely produced from oxygen (O2) occurring in natural air.
Under imaging guidance, a needle is place into the area felt to be the cause of the patient’s pain, with the O2-O3 mixture then injected. Depending on the cause of the patient’s pain, success rates range from 50-80% (1, 2). Of note, the ozone may be injected into a herniated disc, which is of particular benefit in patients who are not surgical candidates and for which other injections are more invasive and costly (3).
Results are best achieved in young patients (less than 50) and when a single disc level is involved (as opposed to multiple levels) (4). The ozone can also be injected into the epidural space, around compressed nerves and into painful back muscles (5).
- Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M. Minimally invasive oxygen-ozone therapy for lumbar disk herniation. AJNR Am J Neuroradiol 24(5):996-1000, 2003
- Muto M, Ambrosanio G, Guarnieri G, Capobianco E, Piccolo G, Annunziata G, Rotondo A. Low back pain and sciatica: treatment with intradiscal-intraforaminal O(2)-O (3) injection. Our experience. Radiol Med 113(5):695-706. Epub 2008 Jul 1, 2008
- Das G, Ray S, Ishwarari S, Roy M, Ghosh P. Ozone nucleolysis for management of pain and disability in prolapsed lumber intervertebral disc. A prospective cohort study. Interv Neuroradiol 15(3):330-4. Epub 2009 Nov 4, 2009
- Oder B, Loewe M, Reisegger M, Lang W, Ilias W, Thurnher SA. CT-guided ozone/steroid therapy for the treatment of degenerative spinal disease--effect of age, gender, disc pathology and multi-segmental changes. Neuroradiology 50(9):777-85. Epub 2008 May 16, 2008
- Paoloni M, Di Sante L, Cacchio A, Apuzzo D, Marotta S, Razzano M, Franzini M, V. Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection. Spine (Phila Pa 1976) 1;34(13):1337-44, 2009
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