Intradiscal ozone therapy: fluoroscopic guidance reduces operative time in comparison with CT guidance in patients with lumbar disc herniation

Radiol Med. 2022 May;127(5):526-533. doi: 10.1007/s11547-022-01469-6. Epub 2022 Mar 15.

Abstract

Purpose: To compare clinical success and operative time for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation using fluoroscopic guidance versus computed tomography (CT).

Materials and methods: During the year 2019, 68 percutaneous single-level intradiscal ozone therapies were performed on patients complaining of low back pain and/or sciatica due to lumbar disc herniation, using fluoroscopic or conventional CT guidance, respectively, in 35 and 32 herniated lumbar discs, with at least 1-month follow-up. Oswestry Disability Index (ODI) was used to assess clinical outcome. Total room utilization time and procedure operative time were recorded for both fluoroscopy and CT guidance.

Results: Fluoroscopy and CT groups were similar in terms of patient age (p value 0.45) and pre-procedure ODI (p value 0.64). Clinical success was obtained in 87.50% (28/32) patients in fluoroscopic group and 83.33% (30/36) in CT group. Mean total room utilization time was significantly longer for CT guidance (31.38 vs. 50.67 min, p < 0.0001), as well as the procedure operative time (15.94 vs. 27.61 min, p < 0.0001).

Conclusions: Compared to conventional CT guidance, fluoroscopic guidance for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation shows similar clinical success rates at 1-month follow-up, with decreased room utilization time and procedure operative time that implies less time consumption for medical and paramedical operative team.

Keywords: CT guidance; Fluoroscopy; Intradiscal therapy; Low back pain; Lumbar disc herniation; Ozone.

MeSH terms

  • Fluoroscopy
  • Humans
  • Intervertebral Disc Displacement* / diagnostic imaging
  • Intervertebral Disc Displacement* / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Operative Time
  • Ozone* / therapeutic use
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Ozone