Ongoing research in ozone treatment for herniated discs shows outcomes similar to surgery, and has researchers predicting that the minimally invasive treatment could soon become standard in the USA.
At the recent annual meeting of the Society of Interventional Radiology, held in San Diego, California 7-12 March, Dr Kieran Murphy, Vice Chair Deputy Chief Medical Imaging, University of Toronto, Canada, predicted that procedure will become standard in the United States within the next five years.
He said that much research in oxygen/ozone treatments has been done by interventional radiologists in Italy and as many as 14,000 individuals have received this treatment abroad over the past five years.
Back pain is the most common cause of job-related disability and a leading contributor to missed work. “Having a herniated disk can affect how you perform everyday activities and can cause severe pain that influences almost everything you do; however, you don’t have to undergo invasive surgery,” said Murphy who has worked on measuring the effectiveness and safety of ozone treatments for herniated lumbar discs as well as ozone’s mechanisms of action for relieving pain associated with herniated discs.
How is oxygen-ozone therapy performed?
Oxygen/ozone therapy involves injecting a gas mixture of oxygen and ozone into a herniated disc. The treatment can limit pain and inflammation by reducing the disc’s volume. Currently, open discectomy and microdiscectomy (both involving removal of disk material through an incision) are the standards in surgical
treatment for herniated disc.
“In oxygen/ozone treatment of herniated discs, interventional radiologists use imaging to guide a needle to inject oxygen/ozone into injured discs. The estimated improvement in pain and function is impressive when we looked at patients who ranged in age from 13 to 94 years with all types of disc herniations,” explained Murphy.
Mechanism of action
“Ozone shrinks disk volume; this is why it provides pain relief,” said Murphy. His team notes that the mechanism of action in relieving low back pain is complex; but the primary effect is a volume reduction of the proteoglycans in the nucleus pulposus.
Murphy’s research has uncovered that a simple incompressible fluid model predicted that reducing disk volume by 0.6% results in an intradiscal pressure reduction of 1 pounds per square inch. Thus a very small change in volume creates a large change in disc pressure, which reduces the applied pressure on the nerve and relieves pain. This model confirmed that a minimalistic alternative to a discectomy, such as oxygen/ozone treatment, is capable of relieving the pain caused by a herniated disk without causing irreparable damage.
Researchers are highlighting that oxygen-ozone therapy is an effective and extremely safe procedure. Also, while pain and function outcomes are similar to the outcomes for lumbar disks treated with surgical discectomy, the complication rate is much lower.
While highlighting the benefits over surgery, Murphy said, “Undergoing invasive surgical discectomy puts you on a path where you may be left with too little disc. Taking out a protruding disc may lose the shock absorption that naturally resides between them in the spine.”
Other advantages over surgery include significantly shorter recovery time for oxygen-ozone treatment over surgical discectomy and a lower complication rate (<0.1%).