1030 PATIENTS TREATED WITH MINIMALLY INVASIVE OZONE DISCOLYSIS IN LUMBAR DISC HERNIATION: 12 MONTHS FOLLOW-UP

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Rosario Blázquez Carrasco
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1 1030 PATIENTS TREATED WITH MINIMALLY INVASIVE OZONE DISCOLYSIS IN LUMBAR DISC HERNIATION: 12 MONTHS FOLLOW-UP Alejandro Ortiz-Basulto M.D. Cesar Alcantara-Canseco M.D. Eduardo Rivero-Sigarroa M.D. Jose Luis Hernandez-Oropeza M.D.

2 BACKGROUND Low back pain and sciatica is a mayor public health problem, according to epidemiologic studies reported by Social Security institutions in Mexico 9 of 10 people through their life has or will have low back pain 84% of all disabilities determined by these Institutions are associated to this pathology Low back pain can also be produced by chemical mediators in which ozone acts immediately In recent years, attention has been focused on the use of medical ozone Published in indexed journals, meta-analysis, even Cochrane Pain relief in more than 80% of patients

3 STATISTICS Descriptive statistics for categorical variables with frequencies and percentages for numerical variables with its corresponding central tendency and dispersion; analyzed with Stata 13 for Mac PURPOSE Examine the use of ozone discolysis as a treatment option for lumbar disc herniation

discolysis in a third level private hospital in Mexico

4 MATERIAL & METHOD Observational, prospective and descriptive study 1030 patients were treated with ozone discolysis in a third level private hospital in Mexico City between 2006 and 2013 With lumbar spine MRI 12 months follow-up

5 RESULTS 1030 patients 1242 discolysis:1.24 ± 0.45 discolysis 1 discolysis = 774 patients 2 discolysis = 216 patients 3 discolysis = 12 patients Age: 52±16 years Without independent analysis between male and female

6 RESULTS BMI 26±2 in females 28±3 in males Levels treated 2±1 per discolysis

7 RESULTS - BEFORE & AFTER DISCOLYSIS

8 RESULTS OSWESTRY DAY ZERO RELEASED DAY IMPROVEMENT % 12 MONTHS IMPROVEMENT % 59.4± ± %±11.5% 15.4± %±7.85% NUMERIC ANALOGUE SCALE 8.5± ± %±13.5% 1.5± %±13.5% SF-36 PF 17.6± ± ±7.7 PR 46.3±25 87± ±17.7 BP 73.1± ± ±7.6 GH 36.4± ±9 82.2±7.9 VT 27.8± ± ±8.2 SF 25± ± ±8.6 ER 33.9± ± ±24.9 MH 28.8± ± ±7.4 MCS 27.9± ± ±12.2 PCS 40.3± ± ±10.2

9 RESULTS Patients treated with discolysis have statistically significant symptoms improvement between good and excellent in >95% which prevails in 94% of the patients with a follow-up of 12 months without pain medication 2.7% of the patients had no improvement and ended in surgery and 2.2% of the patients abandoned treatment

10 CONCLUSION Results suggests that ozone therapy is a useful modality in the treatment of lumbar disc herniation. Discolysis has an important and beneficial effect as a treatment for disc herniation. It also shows statistically significant improved efficacy with a reduced treatment time. Low cost (compared to surgery) minimally invasive ambulatory treatment with over 80% of efficacy and no side effects. Treatment option for acute and chronic lumbodynia and lumbociatica with or without disc herniation

11 CONCLUSION Ozone reduces proteoglycans, micro and macrovacuolar degeneration, interstitial edema so it produces disc dehydration, hernia reduction and disc decompression. Size reduction has been demonstrated by CT scan and MRI Nucleoplasty, chemonucleolysis, discolysis and intradiscal ozone application are known terms for this treatment It blocks different pain and swelling pathways: inhibits pro-inflammatory PGs, produces bradykinin and antagonists of IL-1, IL-2, IL-8, IL-15, INF-α, TNF-α; TGF-β1, IL-10

12 DISCUSION Based on our experience and review of the literature we propose a discolysis as a treatment option for lumbar disc herniation Complementary disc hernia treatment Never forget basic orthopedic principles DISCLOSURE We do not have financial relationships to disclose

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