Ozone-augmented percutaneous discectomy: a novel treatment option for refractory discogenic sciatica
M T Crockett1, M Moynagh1, N Long1
1Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
Clinical Radiology
|September 22, 2014
Summary
Ozone-augmented percutaneous lumbar discectomy (OPLD) effectively treated discogenic sciatica in nearly 75% of patients. This minimally invasive option offers a safe alternative to surgery, reducing the need for further interventions.
Area of Science:
- Minimally Invasive Spine Surgery
- Interventional Pain Management
Background:
- Discogenic sciatica is a common cause of low back pain.
- Patients refractory to initial therapy often require advanced treatment options.
Purpose of the Study:
- To evaluate the short- and medium-term efficacy and safety of ozone-augmented percutaneous lumbar discectomy (OPLD).
- OPLD combines automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural.
- To compare OPLD with caudal epidural for refractory discogenic sciatica.
Main Methods:
- 147 patients with refractory discogenic sciatica were included.
- 50 patients underwent OPLD, and 97 underwent caudal epidural.
- Outcomes assessed using McNab's score, VAS pain score, and need for further intervention at 1 and 6 months.
Main Results:
- OPLD demonstrated success in nearly three-quarters of patients at short and medium-term follow-up.
- OPLD showed superior outcomes compared to caudal epidural at 1 and 6 months.
- The OPLD group required fewer subsequent interventions, with no significant complications.
Conclusions:
- OPLD is a safe and effective second-line treatment for refractory discogenic sciatica.
- OPLD may reduce the need for surgery in this patient population.
- This minimally invasive approach offers a promising alternative for managing chronic back pain.
Related Concept Videos
01:27Degenerative Disc Disease I: Introduction
20
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
20
01:23Degenerative Disc Disease ll: Pathophysiology
19
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
19