Med Bull Sisli Etfal Hosp. 2021; 55(2): 203-209 | DOI: 10.14744/SEMB.2020.55649

Lumbar Intradiscal Ozone Chemonucleolysis Applied Together with the Epidural Steroid Treatment

Mustafa Kilic¹, Tulay Ercalik², Burak Ozdemir¹, Ýlhan Yýilmaz¹, Ali Serdar Oguzoglu³, Levent Aydin¹, Balkan Sahin¹, Ahmet Murat Musluman¹, Adem Yilmaz¹, Haci Mustafa Ozdemir^4
1Department of Neurosurgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
²Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
³Department of Neurosurgery, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
⁴Department of Orthopaedics, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey

Objectives: Intradiscal ozone treatment is a minimally-invasive method that can be applied to patients who have low back pain and do not respond to conservative treatment. This retrospectively designed study aimed to evaluate its clinical efficacy, adverse effects, or complication rates.
Methods: Patients with lumbar degenerative disc disease (LDDD) who underwent intradiscal O2-O3 treatment between January 2016 and April 2018 were included in the study. Pain and disability levels were assessed at pre-injection, 1-month and 1-year post-injection periods using visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively.
Results: A total of 520 patients (270 males and 250 females) with the mean age of 38.9±5.7 years included in the study. First-month and 1st-year post-injection VAS and ODI scores were significantly lower than pre-injection scores (p<0.001). Remarkable VAS score reduction (more than 50%) was found in 60.2% of patients at 1st month and in 52.9% of patients at the 1st year. No important side effects recorded.
Conclusion: Intradiscal ozone therapy applied together with the epidural steroid treatment, one of the percutaneous application techniques for the treatment of low back pain related to LDDD, has successful outcomes, clinical efficacy, and low rate of side effects, and thus, is one of the methods that should be considered before surgery when appropriate patients.

Keywords: Low back pain, ozone chemonucleolysis, percutaneous intradiscal treatment.

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Lomber Ýntradiskal Ozon Chemonucleolysis ile birlikte uygulanan Epidural steroid tedavisi

Mustafa Kilic¹, Tulay Ercalik², Burak Ozdemir¹, Ýlhan Yýilmaz¹, Ali Serdar Oguzoglu³, Levent Aydin¹, Balkan Sahin¹, Ahmet Murat Musluman¹, Adem Yilmaz¹, Haci Mustafa Ozdemir^4
1University of Health Sciences, Þiþli Hamidiye Etfal Training and Research Hospital, Department of Neurosurgery, Ýstanbul, Turkey
²University of Health Sciences, Þiþli Hamidiye Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Ýstanbul, Turkey
³Süleyman Demirel University, School of Medicine, Department of Neurosurgery, Ýstanbul, Turkey
⁴University of Health Sciences, Þiþli Hamidiye Etfal Training and Research Hospital, Department of Orthopaedics, Ýstanbul, Turkey

AMAÇ: Ýntradiskal ozon tedavisi bel aðrýsý olan ve konservatif tedaviye cevap vermeyen hastalara uygulanabilen minimal invaziv bir yöntemdir. Retrospektif olarak tasarlanan bu çalýþma; klinik etkinliði, yan etkileri ve komplikasyon oranlarýný deðerlendirmeyi amaçlamýþtýr.
GEREÇ VE YÖNTEM: Çalýþmaya Ocak 2016 - Nisan 2018 tarihleri arasýnda, lomber dejeneratif disk hastalýðý (LDDD) olan ve intradiskal O2-O3 tedavisi uygulanan hastalar dahil edildi. Aðrý ve iþ görmezlik düzeyleri enjeksiyon öncesi, enjeksiyon sonrasý, postoperatif bir aylýk ve bir yýllýk dönemlerde Görsel Analog Skala (VAS) ve Oswestry Özürlülük Ýndeksi (ODI) kullanýlarak deðerlendirildi.
BULGULAR: Yaþ ortalamasý 38.9 ± 5.7 yýl olan toplam 520 hasta (270 erkek ve 250 kadýn) çalýþmaya dahil edildi. Enjeksiyon sonrasý birinci ay ve birinci yýl VAS ve ODI skorlarý enjeksiyon öncesi skorlardan anlamlý olarak düþüktü (p <0.001). VAS skorunda azalma (% 50'den fazla) birinci ayda hastalarýn% 60.2'sinde ve ilk yýlda hastalarýn% 52.9'unda bulundu. Önemli bir yan etki kaydedilmedi.
SONUÇLAR: LDDD ile iliþkili bel aðrýsýnýn tedavisi için perkütan uygulama tekniklerinden biri olan epidural steroid tedavisi ile birlikte uygulanan intradiskal ozon tedavisinin; baþarýlý sonuçlarý, klinik etkinliði ve düþük yan etki oraný vardýr. Uygun hastalarda ameliyattan önce düþünülmesi gereken yöntemlerden biridir. (SETB-2020-05-074)

Anahtar Kelimeler: perkütan intradiskal tedavi, bel aðrýsý, ozon kemonükleozis

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