Abstract
BACKGROUND AND PURPOSE: Direct injection of Oxygen-Ozone in to the discs has proved to be the effective alternative for surgery in patients with disc herniation in many countries around the world. We report our experience with ozonucleolysis with patients effected by lower backache, sciatica and pain cervical region (brachalgia) due to disc herniation including post operative recurrence or disc prolapse.
 
 MATERIAL & METHODS: Twenty-Three Thousand patients were treated with single two multiple sessions of Oxygen Ozone therapy. All the patients had CT or MRI evidence of annulus tear/ disc prolapse with clinical signs of nerve root compression. The procedure was performed under angio fluoroscopy using 22/23 G spinal needle without any form of anesthesia. All the patients received intra discal injection of Oxygen Ozone mixture with and without periganglionic infiltration at a ozone concentration 30 mcgr/mL. Among these patients 14000 were males and 9000 were females between the age of 14-80 years. Therapeutic outcome was assessed 5 months after treatment by using modified MacNab method.
 
 RESULTS: A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain and with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit.
 
 CONCLUSION: Intradiscal with and without periganglionic injection of Ozone for herniated discs has revolutionized percutaneous approach to nerve root diseases making it safer, cheaper and easier to repeat than treatments currently use in Pakistan.
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