Ozone therapy, also known as ozone discectomy, is used commonly for disc prolapse (slipped disc), nerve root compression, facet joint pain & spondylosis. These are all conditions related to the spine. It was developed in Italy and it has become popular globally, as it has proven to be safe and effective. With a success rate of 80% to 90% and almost 0% rate of complications, it has many advantages over open surgical procedures.
Confirmation of the needle in L4-5 disc seen on X-ray before the injection of ozone
What is the mechanism of ozone?
Ozone is a powerful oxidant. It immediately dissolves in the extra cellular fluid and reacts with a number of molecules present in biological fluids, namely antioxidants, proteins, carbohydrates, and polyunsaturated fatty acids.
In the inter vertebral disc ozone (O3) dissociates to O2 and an atom of oxygen, and after some time various chemical processes mean that it causes shrinkage and mummification of the disc and relief to the compressed nerve root.
Here, we use 3 to 5ml solution of freshly prepared ozone gas, with a concentration of 30 microgm/ml.
How do you inject the ozone gas into the affected area or disc?
After the desired structure or disc can be seen clearly (by positioning Pt. in prone and the 'C' arm in oblique), skin is marked and under all aseptic precautions the proper length needle is passed under X-ray control to the desired site. The position of the needle is confirmed by putting radio-contrast dye, and then ozone is injected.
How does it help in root compression, sciatica, or facet joint pain?
Ozone also exerts anti-inflammatory actions. Because of this edema is reduced, venous congestion is reduced and blood supply is improved. This gives pain relief.
How many times is this procedure done?
Usually we don't repeat intradiscal injection of ozone. For nerve roots or facet joints usually 4-6 injections (once weekly) are required. But subsequent injections are given in paravertebral space which are simple to carry out and less expensive.
Is ozone therapy effective?
Overall there is a 80-90% success rate which is comparable to or better than surgery. Moreover, the pain relief is good in the long term, and lasts usually more than a year or so.
What are the advantages of it over surgical procedures?
It is done as a day care procedure. There is no need of general anaesthetic. There is no need of admission in hospital. It can be done in a relatively unfit patient, and also in old age. Complications are almost nil. In the long run there are no adhesions like surgery, so doing the procedure again in future is easy compared to surgery.
Does it or can it cause spinal unstability?
The risk of this is nil in this procedure, like surgery. As the structures are not dissected and only a needle is used, there are no chances of adhesions or spinal unstability.
Is it cost effective?
Yes, compared to surgical methods, it is very cost effective.
Injection of ozone at the end of procedure