Продолжение.
ID 105
Follow-up disc-root compression and post-surgical radiculopathies with paravertebral oxygen-ozone
L. Valdenassi, G. Nardelli, P. Richelmi, and F. Bertè
Dept. of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
Background: Disc-root compression is increasingly treated by oxygen-ozone injections following the positive outcome of therapy reported in the literature. The aim of the current study is the presentation of the effects of oxygen-ozone therapy relating to a clinical follow-up.
Materials and methods: We assessed the validity of this therapy in a prospective study on 240 patients (two groups according to etiopathogenesis): group 1: 188 patients with herniated disc and disc-root compression, group 2: 52 patients with radiculopathy related to post-surgical fibrosis. All patients have received paravertebral injections with oxygen-ozone in 10 sessions. Outcome was analysed with clinical test, subjective evaluation and TC. All specifics symptoms were examinated after therapy, then 6 months later and so again 1 year and 4 years later.
Results: Were obtained excellent results in the first group: 95 patients (51%) have complete or marked resolution of symptoms; goods results in the second: 65 (35%) with major reduction of symptoms and little or no benefit 28 (15%).
Among second group the results were not as good: excellent results were obtained in 17 patients (33%), good in 15 (29%). Whereas negative results in 18 patients (35%).After 1 year results were the same, only 2 patients of the first group and 5 of the second have relapse of symptoms. After 4 years 6 patients of the first group and 5 of the second demonstrated relapse of symptoms.
Conclusions: According to analysis of follow-up, oxygen-ozone therapy is an effective treatment for disc-root compression and post-surgical radiculopathy also after a long time.
ID 167
Intrasacral epidural injection with oxygen-ozone for the treatment of low back pain. Comparison and evaluation with other techniques and rehabilitation and return to work.
I. Mattozzi, Gp. Laurini, G. Muzzi,M. Franzini*, and A. Bigiotti
Department of Anesthesia, Reanimation ASL Viterbo, Italy; *T. Oxygen Ozone Therapy University of Pavia, Pavia, Italy
Background: Low back pain caused by hernia and/or protrusion of the disks L4-L5 and or L5 S1 is among the most frequent causes of abstention from work in Western Countries.The caudal epidural block is often used in the treatment of chronic pain.
Materials and methods: We administered an intrasacral epidural injection to a group of patients, all of whom were free-lance workers affected by low back pain, using a mixture of 20 ml of O2 O3 to the concentration of 20 µgr/ml by means of the medical device Multiossigen Medical 99 IR, ISO 9002. This methodology has been compared with others and evaluation has been made in terms of rehabilitation and a speedy return to work.
Result: The Intrasacral epidural injection with O2-O3 has shown a greater effect on the pain and a greater effectiveness in allowing the patient to return to his normal working activity.
Conclusions: In experienced hands, this easily used technique which carries no risk of neurological damage, represents a valid opportunity for the patient to return to his work-place in the briefest time possible.
ID 173
Postural diagnosis importance in the root – disc conflict pathology
L. Mascolo, A. Sammartino, M. Luongo, V. Villani, C. Cipollaro, and C. Luongo
Clinica Villa dei Fiori, Serv. Di terapia Iperbarica e Ozonoterapia, Acerra (Naples), Italy
In the past 15 years about 10% of patients suffering from root – disc conflict pathology didn’t respond positively to an infiltration therapy based on oxygen-ozone mixture administered 2 times a week.
Today we can verify, using a complete examination which includes bone and articular system, muscular, tendineous, nervous and vascular systems, that the painful symptoms of the root – disc conflict pathologies can be due or sustained by pathologies of the temporal-mandible joint and/or changes of the plantar arch support.
The above-mentioned examination consists of the step emission of electric impulses (6v) from electrodes applied on the patient’s head, hands and feet.
A dedicated software is able to collect and analyze the impulses steps pattern. The software is able to produce a diagnosis based on a known pattern similarity.
Using this system we can verify that many pathologies of the loin-sacral area are caused by a postural ascending change and/or a so-called descending change of the temporal-mandible joint.
The system allows the definition of the most correct dosage of the oxygen-ozone mixture we have to seep through in the areas indicated by the system itself.
Conclusion: This diagnostic - therapeutic system, used on about one hundred patients so far, let us observe a disappearance or a significant reduction of the viral charge in about 90% of treated patients.
ID 197
Chemodiskolysis and periradicular and periganglionic infiltration with oxygen-ozone in disk herniation
C. Andreula1, M. Leonardi2, and M. Bonetti3
1Neuroradiology, a.o. Policlinico-consorziale, Anthea Hospital, Bari, Italy; 2Neuroradiology a.o. Bellaria, Bologna, Italy; 3Neuroradiology Gruppo San Donato” (Istituto Clinico Città di Brescia,Iistituto Policlinico San Donato Milanese), Italy
Background: The success in surgically operated patients for lumbar-sacral disk herniations is about 80-85%, for the Failed Back Surgery Sindrome with severe symptoms in 20%. For these results new techniques (spinal procedures) were considered to reduce the surgical approach and the undesired infectious complications. We report our experience with chemodiskolysis with oxygen-ozone
Material, method, results: In a 2-years period we treated more than 1000 patients by Chemiodiskolysis and periradicular and paraganglionic infiltration with Oxygen-ozone mixture, excellent and good results in 74% and unsatisfactory (bad) results in 26%. We do not report any complications: diskitis may occur but strict surgical asepsis of the procedure will avoid it. The patients who fail to benefit from this percutaneous treatment are referred to surgery without any negative effects.
Conclusions: The mechanisms of ozone action are: 1. Reduction of the volume of the nucleus pulposus, 2. Reduction of the inflammation for oxidative action on the pain mediators, 3. Better microcirculation: the sensitive nervous roots are sensible to hypossia
1. .
The good results achieved using this techniques, with very low risk of complications and very low cost, suggest chemodiskolysis and periradicular and periganglionic infiltration with oxygen-ozone mixture as the procedure of choice, in patients with sciatica for contained disk herniation without any motor symptoms.
ID 198
Combined effect of O2/O3 and GPR in treatment of lumbar disc herniation. Anatomical, clinical, and patient-self-report evaluation
D. Apuzzo1, M. Franzini2, L. Di Lucente3, M.C. Gioia3, A. Cerasa3, U. Sabatini3, and A. Castriota-Scanderbeg3
2Dept. of Physical Medicine and Rehabilitation, University di Pavia, 1Studio Medico Apuzzo, Rome, Italy, 3 Fondazione IRCCS Santa Lucia, Rome, Italy
Background: Experimental studies indicate that the O2/O3 increases the micro-vascular activity, induces neo-angiogenesis and facilitates the elimination of toxic metabolite. Global Postural Re-education (GPR) re-equilibrate posture by training the muscles of the spine. We evaluated the anatomical clinical and patient-self-report effects induced by combined O2/O3 and GPR treatment of lumbar disc herniation.
Materials and methods: We studied 40 patients suffering from lumbar disc herniation. They were assessed before and after combined O2/O3 and GPR treatment with MRI, Valleix points, Lasegue test, Role functioning Physical and General Health sub-scales of SF-36 test and numeric-non-verbal scale for pain evaluation. The O2/O3 infiltration and the GPR were repeated for about 22 times at different frequency along 6 months.
Results: Post treatment MRI revealed that 47% of patients had a reduction of the hernia volume. The clinical outcome showed a significant reduction of symptoms (Valleux points p<0.0001 and Lasegue test p<0.001). Mainly each patient had reduction of pain (p<0.0001) and did improve his quality of life (p<0.001) i.e. work or daily activities had been resumed to pre-symptomatical levels.
Conclusions: It has to be point out that the percentage of hernia volume reduction of those patients who underwent any conservative treatment is similar to the percentage reduction we found in our series. Nevertheless, combined O2/O3 and GPR significantly reduce the feeling of pain and do improve the quality of life in these patients.
(Preliminary data of this study have been presented to the ASOO, November 2002, Forte dei Marmi, Italy).