title: Oxygen-ozone therapy for herniated lumbar disc in patients with subacute partial motor weakness due to nerve root compression.
abstract: Intradiscal oxygen-ozone (O2-O3) chemonucleolysis is a well-known effective treatment for pain caused by protruding disc disease and nerve root compression due to bulging or herniated disc. The most widely used therapeutic combination is intradiscal injection of an O2-O3 mixture (chemonucleolysis), followed by periradicular injection of O2-O3, steroid and local anaesthetic to enhance the anti-inflammatory and analgesic effect. The treatment is designed to resolve pain and is administered to patients without motor weakness, whereas patients with acute paralysis caused by nerve root compression undergo surgery 24-48h after the onset of neurological deficit. This paper reports on the efficacy of O2-O3 chemonucleolysis associated with anti-inflammatory foraminal injection in 13 patients with low back pain and cruralgia, low back pain and sciatica and subacute partial motor weakness caused by nerve root compression unresponsive to medical treatment. All patients were managed in conjunction with our colleagues in the Neurosurgery Unit of Bellaria Hospital and the IRCCS Institute of Neurological Sciences, Bologna. The outcomes obtained are promising: 100% patients had a resolution of motor weakness, while 84.6% had complete pain relief. Our results demonstrate that O2-O3 therapy can be considered a valid treatment option for this category of patients.
authors.affiliation: Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy - mdallolio@gmail.com.
authors.forename: Massimo
authors.initials: M
authors.lastname: Dall'Olio
authors.affiliation: Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Princiotta
authors.affiliation: Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy - DIMES, Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna; Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cirillo
authors.affiliation: Radiodiagnostics Specialization School, University of Bologna; Bologna, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Budai
authors.affiliation: Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: de Santis
authors.affiliation: Neurosurgery Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bartolini
authors.affiliation: Neurosurgery Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Serchi
authors.affiliation: Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy - DIMES, Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna; Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Leonardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy; D008161:Lumbosacral Region; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology*; D010100:Oxygen / Q000008:administration & dosage* / Q000627:therapeutic use*; D010126:Ozone / Q000008:administration & dosage* / Q000627:therapeutic use*; D018579:Patient Selection; D013117:Spinal Cord Compression / Q000150:complications* / Q000188:drug therapy; D013126:Spinal Nerve Roots; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D010126:Ozone; D010100:Oxygen; D008775:Methylprednisolone
keywords: herniated lumbar disc; low back pain; motor weakness; nerve root compression; oxygen-ozone therapy