Role of ozone Disc Nucleolysis in Herniated intervertebral Disc: The Indian experience

Abstract

Aim: To study the role of ozone disc Nucleolysis in herniated intervertebral disc 
 Materials: We retrospectively analysed consecutives patients undergoing ozone disc nucleolysis. There were Total of 5265 patients with 2740 males and 2525 females .their Age was ranging from 17yrs to 84 years. Patients weight was ranging from 36 to 138 kilograms. All the patients had failed conservative management for at least 3weeks. 
 Methods: All the patients were clinically evaluated as per inclusion and exclusion criterions. Pre-treatment Visual Analogue scale (VAS)and Oswestry Disability Index (ODI).All the patients undergone Pre-treatments work up of MRI of the spine.256 patients were undergone Nerve physiological study(EMG,NCV and SSEP).All the procedures were carried out in Cathlab (Siemen's Artis zee) under local anaesthesia. In Lumbar region 3 cc of ozone and in cervical 1cc of ozone-oxygen mixture injected .In Lumbar region additionally 7cc of ozone –oxygen mixture along with local anaesthetic(Lidocaine) –corticosteroid(Hydrocortisone and triamcinolone) –rheological enzyme (hynidase) injected in epidural space. There were 4406 patients with Lumbar disc herniation and 861 patients with cervical disc herniation. Statistical Analysis was done by SAS online version 2 Results: Outcome was assessed by VAS score, Oswestry Disability Index and modified MacNab scale at 6 month, 12 months and 18 months The mean baseline VAS score was 9 which became 4.9 post ozone disc nucleolysis . Disability Index was 36.13 at baseline which improved to 9.86 post treatment. Success rate was 81% by Modified MacNab outcome scale. Results by all above mentioned the three methods were found to be statistically significant. Conclusion: Ozone disc nucleolysis is highly effective in the treatment of herniated intervertebral disc .It is safe, Durable and cost effective in our series. Our results were slightly better than the published literature. However randomised control trial is recommended to further substantiate our results.