Abstract
Background: Paravertebral injection of ozone is an established clinical practice for the treatment of Low Back Pain (LBP). The role of Ultrasound Guidance (USG) in mini invasive procedures has become important in many clinical practice thanks to the greater precision this technique can add. As matter of fact, a large volume of ozone in a single administration may have some adverse or side effects. In this study we wanted to verify if the use of USG in Oxygen/ Ozone (O2/O3) infiltrations could allow the administration of a smaller volume of gas mixture, increasing the safety and the comfort of the procedure itself, obtaining however similar or better results in pain decrease. Methods: We compared two groups of 25 patients affected by LBP, undergoing 10 infiltrations of O2/O3, by using USG (group U) or only anatomical landmarks (group AL). Pain intensity, by calculating Visual Analogical Scale (VAS) difference before and after the treatment, and the discomfort were evaluated in both groups. Results: The mean of the VAS before the treatment was 6.44 in group U and 6.48 in group AL. The mean of the VAS after the treatment was 2.22 in group U and 3.04 in group AL. The mean of discomfort rate was 2.84 in group U and 5.44 in group AL. The number of patients with unbearable discomfort was 0 in group U and 7 in group AL. Conclusions: As many other treatment, also paravertebral injections of O2/O3 benefits of the advantages of the US device which makes this treatment safer and more accurate.
Highlights
Low Back Pain (LBP) is a frequent and economically relevant disease with a cumulative life incidence of 70%
The efficacy of ozone in the treatment of LBP is very well stated by Megalhães’ analysis [4] but, as all mini invasive procedures, it may have side effects caused by the procedure itself as well as gas infiltration [7]
As a matter of fact, large volume of ozone in a single administration may have the following adverse or side effects [7,8,9]: acute muscular pain and deep visceral pain with high incidence of symptoms and exacerbation of the functio laesa, fatal air embolism due to erroneous injection of a big volume of gas in a blood vessel, burning and heaviness sensation, various complications caused by improper use of gas mixture
Summary
Low Back Pain (LBP) is a frequent and economically relevant disease with a cumulative life incidence of 70%. It is one of the most causative for long-lasting disability and the most common cause of invalidity in the population with an age >45 years [1,2,3]. The aim of our study was to evaluate the use of Ultrasound Guidance (USG) to practice O2/O3 infiltrations in order to enhance better identification of the anatomical landmarks and the need for a smaller volume of O2/O3. In this study we wanted to verify if the use of USG in Oxygen/ Ozone (O2/O3) infiltrations could allow the administration of a smaller volume of gas mixture, increasing the safety and the comfort of the procedure itself, obtaining similar or better results in pain decrease
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