The anatomy of pain relief: Lumbar oxygen-ozone epidural infiltrations for cervicobrachialgia

Luca Faccioli, Giulio Vara, Luca Spinardi, Marco Pastore Trossello, Gianfranco Vornetti, Mattia Gentilini, Stefano Ratti

Article ID: 4781
Vol 6, Issue 1, 2023

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Abstract


Objective: This study investigates the efficacy and safety of epidural infiltration with drugs and an oxygen-ozone mixture for treating cervicobrachialgia due to disc-radicular conflict or on a degenerative basis, utilizing both retrospective analysis and direct visualization techniques. Methods: A retrospective study involving 10 patients treated with epidural infiltrations of an oxygen-ozone mixture and cortisone was conducted. The procedures were performed under CT guidance to ensure precise delivery and to monitor the diffusion of the injected substances. Pain levels were assessed using the Numerical Rating Scale (NRS) and treatment efficacy was evaluated based on symptom relief and reduction in NSAID intake. Results: Significant pain reduction was observed post-treatment, with median NRS scores decreasing from 9 (baseline) to 2 (follow-up), and a significant decrease in on-demand NSAID intake. Only one minor complication of a headache was reported. The study also demonstrated the ability of ozone to diffuse through the epidural adipose tissue, potentially enhancing treatment efficacy. Conclusion: The combined use of an oxygen-ozone mixture and cortisone for epidural infiltration is an effective and safe treatment for cervicobrachialgia, offering significant pain relief and minimizing the risk associated with traditional epidural injections. This technique presents a viable non-surgical option for patients suffering from disc-radicular conflict or degenerative conditions.


Keywords


interventional radiology; peridural; ozone; cervicobrachialgy; radiculopathy

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References


1. Schoenfeld AJ, George AA, Bader JO, et al. Incidence and Epidemiology of Cervical Radiculopathy in the United States Military. Journal of Spinal Disorders & Techniques. 2012; 25(1): 17-22. doi: 10.1097/bsd.0b013e31820d77ea

2. Radhakrishnan K, Litchy WJ, O’Fallon WM, et al. Epidemiology of cervical radiculopathy. Brain. 1994; 117(2): 325-335. doi: 10.1093/brain/117.2.325

3. Wong JJ, Côté P, Quesnele JJ, et al. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. The Spine Journal. 2014; 14(8): 1781-1789. doi: 10.1016/j.spinee.2014.02.032

4. Kim YK, Kang D, Lee I, et al. Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease’s Association with Work. International Journal of Environmental Research and Public Health. 2018; 15(10): 2094. doi: 10.3390/ijerph15102094

5. Iyer S, Kim HJ. Cervical radiculopathy. Current Reviews in Musculoskeletal Medicine. 2016; 9(3): 272-280. doi: 10.1007/s12178-016-9349-4

6. Woods BI, Hilibrand AS. Cervical Radiculopathy. Journal of Spinal Disorders & Techniques. 2015; 28(5): E251-E259. doi: 10.1097/bsd.0000000000000284

7. Beyaz SG. Six-Month Results of Cervical Intradiscal Oxygen-Ozone Mixture Therapy on Patients with Neck Pain: Preliminary Findings. Pain Physician. 2018; 1(21; 1): E499-E456. doi: 10.36076/ppj.2018.4.e449

8. He X, Xiao YY, Li YH, et al. Percutaneous Intradiscal O2-O3 Injection to Treat Cervical Disc Herniation. Rivista di Neuroradiologia. 2005; 18(2_suppl): 75-78. doi: 10.1177/19714009050180s215

9. Muto M, Giurazza F, Silva RP, et al. Rational approach, technique and selection criteria treating lumbar disk herniations by oxygen–ozone therapy. Interventional Neuroradiology. 2016; 22(6): 736-740. doi: 10.1177/1591019916659266

10. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999; 354(9178): 581-585. doi: 10.1016/S0140-6736(99)01312-4

11. Desmoulin GT, Pradhan V, Milner TE. Mechanical Aspects of Intervertebral Disc Injury and Implications on Biomechanics. Spine. 2020; 45(8): E457-E464. doi: 10.1097/brs.0000000000003291

12. Brooks M, Dower A, Abdul Jalil MF, et al. Radiological predictors of recurrent lumbar disc herniation: a systematic review and meta-analysis. Journal of Neurosurgery: Spine. 2021; 34(3): 481-491. doi: 10.3171/2020.6.spine20598




DOI: https://doi.org/10.24294/irr.v6i1.4781

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