How is a herniated disc treated?

  Disc herniation is a chronic disease that has plagued people’s health for a long time, with a high incidence and a wide range of people involved. In recent years, the popularity of imaging methods has led to a more detailed understanding and diagnosis of this disease. The clinical manifestations and imaging changes of disc herniation can be complex and varied depending on the patient’s disease duration, the degree of degenerative rupture of the disc annulus fibrosus, the presence or absence of nucleus pulposus, the presence or absence of nerve root adhesions, and the presence or absence of secondary changes in the ligamentum flavum and bony spinal canal structures. There is no single treatment that can cure all the different courses of herniated discs. Therefore, the treatment of herniated discs should be individualized and even intervertebral discized by selecting suitable and targeted therapeutic measures according to the herniated disc.  Generally speaking, the early treatment of disc herniation using rehabilitation physiotherapy can enable some patients to recover. With the recurrence and development of the disease, conservative treatment is ineffective and interventional treatment should be adopted; those who cannot achieve the treatment purpose with interventional treatment should then consider surgery. It is a gradual process from the early onset of disc herniation to the emergence of multiple comorbidities in the late stage. Patients often seek a suitable treatment method according to their painful condition from the perspective of treatment trauma and economic considerations. At present, many domestic medical practitioners are involved in the treatment of disc herniation and have their own treatment characteristics, often using their own preferred treatment methods to treat different conditions of disc herniation, making it difficult to achieve a high degree of targeting or individualization of treatment, not to mention intervertebral discization.  O3 ablation is an emerging interventional technology in China in recent years, and this technology has a history of several decades in foreign countries, especially in Europe, for the treatment of disc herniation and has achieved very good results. The half-life of O3 is about 20-30 minutes at room temperature. 60ug/ml of O3 can fully oxidize and decompose proteins and polysaccharide macromolecules in the nucleus pulposus, and the volume of the nucleus pulposus is gradually reduced after oxidation, and the pressure on the nerve root disappears; the nucleus pulposus that overflows when the fiber ring is completely ruptured has strong chemical irritation to the nerve root, causing chemical inflammation of the nerve root; in addition, the nucleus pulposus has immunogenic properties. contact with the nerve root can cause immune inflammation. The injection of O3 around the nerve root can oxidize the nucleus pulposus structure on the surface and around the nerve root, eliminating its chemical irritation and immunogenicity without any damage to the nerve root and dural structure, while O3 has anti-inflammatory and analgesic effects. Among the three tissue structures that constitute the cartilage end plate, fibrous ring and nucleus pulposus of the intervertebral disc, the nucleus pulposus has the highest content of proteoglycans, reaching 40C60% of the dry weight of the nucleus pulposus, while O3 can specifically oxidize proteoglycans and has little effect on the fibrous ring and cartilage end plate. Therefore, O3 at the appropriate concentration is more targeted, less traumatic and has fewer complications. Animal experiments have shown that the nucleus pulposus shows progressive atrophy after O3 oxidation, and pathological examinations have confirmed that the nucleus pulposus structure is completely atrophied and solidified after 3 months, and clinical observations have also shown that the most desirable results can be obtained only after 3 months of O3 treatment. The combination of laser and radiofrequency ablation with O3 can significantly expand the indications and provide therapeutic effects. Similarly, O3 injection alone cannot be used for all herniated discs, and the use of ozone can be expanded by combining it with other methods to improve the cure rate.  In conclusion, in order to improve the cure rate of disc herniation, it is important to cultivate multi-disciplinary talents, interdisciplinary technical cooperation, and rational selection of combined interventional techniques to make the treatment of disc herniation truly individualized or interdisc-oriented.