1.Background of the application of ozone therapy
Herniated disc is a common disease and multi-infarct, domestic and foreign research data show that 50-60% of the population has lumbar pain at different times in their lives, and about 20% of the patients with lumbar pain in outpatient clinics are herniated discs. It is estimated that the number of patients with lumbar disc herniation in China should be more than tens of millions, and the number of new cases is about 3 million every year. Traditional Chinese medicine treatment is conservative treatment, including physiotherapy, massage, acupuncture, Chinese herbal medicine, etc., and then small needle knife and sacral injection were added. Although there is a certain degree of efficacy, it is not easy to consolidate and the symptoms tend to recur. Surgical operation is a kind of radical treatment, but due to people’s concern about the risk and cost of surgery, as well as the damage to tissues caused by surgery itself, resulting in complications such as medical trauma and postoperative adhesions, the embarrassing situation of “surgery is successful, but the pain remains”.
In the 1960s, minimally invasive treatment methods were introduced to treat herniated discs, including papain and collagenase injections in the early days, percutaneous nucleus pulposus removal in Japan in the 1970s, and incisional suction and laser ablation in the United States in the 1980s, which led to the development of minimally invasive treatment. The efficiency can reach 70-80%, and is now commonly used in European countries. Nowadays, nearly 200 hospitals in China have carried out minimally invasive ozone injection, and thousands of cases of ozone injection lysis have been done, which have achieved very good results. Since the introduction of this equipment in August this year, the pain department of our hospital has achieved satisfactory results in the treatment of acute radicular pain caused by disc herniation and cold numbness of lower limbs due to sympathetic nerve dysfunction by puncturing the lateral saphenous fossa. This treatment method has the advantages of easy operation, slight or no trauma, high efficiency, fast recovery and few complications compared with traditional methods, and is well received by patients.
2.The principle of ozone therapy for herniated disc
According to the available information, the main causes of disc herniation leading to back and leg pain are twofold: mechanical compression of nerves, aseptic inflammation of nerve roots and nutritional disorders of nerve roots and conduction damage of nerve roots.
Ozone has strong oxidizing ability, and when it is injected into the nucleus pulposus of the herniated disc, it can instantly oxidize the proteoglycans in the nucleus pulposus and destroy the nucleus pulposus cells, so that the function of proteoglycans is lost, the cells produce less proteoglycans, and the osmotic pressure of the nucleus pulposus cannot be maintained, resulting in water loss and atrophy, thus reducing the pressure in the disc, eliminating the symptoms and achieving the purpose of treatment. At the same time, ozone has anti-inflammatory and analgesic effects, which can eliminate sterile inflammation in the nerve root, thus achieving a radical healing effect.
3.The advantages of ozone therapy for herniated disc
In addition to the common advantages of other minimally invasive treatments for herniated discs, ozone therapy has its unique advantages.
(1) High safety factor, fine needle puncture under localization, mainly acting on the nucleus pulposus, with no effect on other tissues.
(2) Minimally invasive treatment is less risky and painless, more effective than conservative treatment, while eliminating the pain of incision.
(3) Precise positioning. (3) Precise positioning. Accurate positioning under X-ray fluoroscopy, no deviation.
(4) No significant complications. Ozone itself has a sterilizing effect, and the chance of infection is greatly reduced.
4.Ozone therapy for herniated disc indications
(1) bulging and mild to moderate herniation combined with radicular compression symptoms.
(2) obvious clinical symptoms, including persistent back and leg pain, claudication, etc.
(3) Positive signs of spinal nerve compression or abnormal skin sensation, such as positive straight leg raise test, etc.
(4) The effect of conservative treatment is not effective.
(5) Diagnosis of inclusive or simple disc herniation or bulge confirmed by imaging such as CT or magnetic resonance imaging, and the imaging manifestations are consistent with clinical symptoms and signs.
(6) The results of surgical treatment or other minimally invasive treatment of the disc are not satisfactory.
(7) Conservative treatment but long-standing low back pain, no obvious nerve compression symptoms, but the imaging confirmed that there are planes of disc lesions (such as disc bulge), and exclude other causes.
5.Post-operative precautions for ozone treatment of herniated discs
(1) Prone for 1-2 hours after surgery to prevent ozone spillage from affecting the therapeutic effect.
(2) Within 3 days after surgery, it is recommended to rest on a hard bed and prohibit strenuous activities on the ground.
(3) Wear a suitable waist brace after waking up, and the entire use time of 3-6 weeks is appropriate.
(4) Routine application of antibiotics and dehydrating agents after surgery, generally used for 3 days.