Intradiscal ozone therapy for lumbar disc herniation.

The rationale behind intradiscal O2-O3 therapy is the pain elicited by the mechanical compression of the nerve root, which is associated with periganglionic and periradicular inflammation. This study aimed to determine the effect of intradiscal ozone injection on pain score and satisfaction of patients with low back pain (LBP) secondary to disc herniation. Patients with LBP diagnosed with disc herniation were enrolled in this clinical trial. After prepping and draping the area, intradiscal injection of ozone/oxygen mixture (10 ml, 25µg/ml) was performed under fluoroscopy guide (c-arm). Pain score and patient satisfaction were assessed prior to the injection (baseline) and 1, 3, 6, 12 and 24 months after the injection. Sixty three patients (24 males, 39 females) with mean age of 53.3 ±2.0 y enrolled in the study. The mean±standard deviation (SD) of pain score before intervention was 6.968 ±0.11. Pain score was reduced to 4.25±0.19 at 1 month, 4.33±0.20 at 3 months, 4.87 ±0.21 at 6 months and 5.22 ±0.20 at 24 months. According to the modified MacNab scale success of pain relief was as follows: excellent: 4 (6.3%), good: 17 (26.98 %), sufficient: 13 (20.63 %), poor: 13 (20.63 %), no result: 11 (17.46%), negative: 4 (6.3 %). Intradiscal ozone therapy was determined to provide improved outcomes in patients with single level of bulging and protrusion.

[Comparison of non-invasive and invasive techniques in the treatment of patients with myofascial pain syndrome]. / Miyofasiyal agri sendromlu hastalarin tedavisinde non-invazif ve invazif tekniklerin karsilastirilmasi.

OBJECTIVES: We compared in this study the efficiency of non-invasive techniques including transcutaneous electrical nerve stimulation (TENS) and laser treatments with invasive techniques including lidocaine and botulinum toxin-A injection in patients with myofascial pain syndrome (MPS). METHODS: One hundred patients who admitted to Firat University Hospital Pain Department and who were diagnosed as MPS were included in the study. Patients were randomized into four groups of 25 patients each. Sixty sessions of TENS and 20 sessions of laser treatments were performed in the first and second groups, respectively. Lidocaine and botulinum toxin-A were injected in the third and fourth groups, respectively. 2 ml (20 mg) 1% lidocaine was injected in each patient twice a week for one month in Group III. 25 U (0.5 ml) of botulinum toxin-A was injected in each patient only once in Group IV. Pain was evaluated with visual analogue scale (VAS), palpable muscle spasm scoring (PMSS) and anesthesiometer at baseline, 15, 30 and 45 days. RESULTS: There were no statistically significant differences between the groups with respect to age, sex and education level. Pain control was statistically better in Group IV compared with the other groups with respect to VAS, PMSS and anesthesiometer scores. CONCLUSION: Botulinum toxin-A injection provided better pain control when compared to trigger point injection with lidocaine and non-invasive techniques including TENS and laser treatments.