International Surgery Journal | October-December 2016 | Vol 3 | Issue 4 Page 2092 International Surgery Journal Yadav K et al. Int Surg J. 2016 Nov;3(4):2092-2097 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Role of ozone nuleolysis in management of discogenic pain in lumbar and lumbosacral disc prolapse Kuldeep Yadav 1 , Priyesh Bhaskar 2 *, Anita Jagetia 3 , Mohd. Kaif 1 INTRODUCTION In every day’s life lower back pain is a major cause of morbidity. In 50% cases it is associated with radicular symptoms. 1 The causes of variable success are considered to be epidural fibrosis, arachnoidal adhesions, muscle and fascial fibrosis, and or mechanical instability. Mixter and Barr proposed prolapsed lumbar and lumbosacral inter- vertebral disc as a cause of low back pain. 2 For the reasons of safety and efficacy ozone nucleolysis is becoming widely used intermediate procedure between conservative therapy and surgery, to alleviate pain, decompress the nerve roots and to maintain the structural stability, in cases of disc prolapse. 3 A prevalence of 30 percent has been found to be associated with chronic low back pain in Unites States. 4 The mechanisms of action include analgesic, anti- inflammatory and oxidant actions which work together to cause symptomatic and radiological improvements in disc prolapse. Active oxygen atom is liberated from breaking down of ozone molecule. When ozone is injected into the ABSTRACT Background: Discogenic low back pain is a common symptom. Over the years many percutaneous minimally invasive therapeutic modalities have evolved. Intradiscal oxygen-ozone therapy is one of them and has showed promising results. We undertook a prospective study to evaluate the therapeutic outcome of intradiscal oxygen-ozone therapy on patients with lumbar and lumbosacral disc prolapse in the Indian population. Methods: Fifty consecutive patients complying with selection criteria were included in this study with clinico- radiologic diagnosis of lumbar and/or lumbosacral disc prolapse. All patients received ozone-oxygen mixture in the disc, in neural foramen and root canal and in facet join region and para-vertebral muscles at concentration of 29-40 mcg/mL. Therapeutic outcome was assessed after four weeks, three months, and six months post-procedure, on visual analog scale (VAS), Oswestry low back pain disability questionnaire (ODI) and Modified MacNab methode. Results: Pain intensity was significantly reduced following treatment (from baseline mean VAS 8.46±0.67 to 3.8±1.29 at one month, at three months 3.1±0.7 and at six months follow up 3.78±1.13, p < 0.0001). Similarly the ODI and modified MacNab criteria showed a remarkable improvement in the functional status of the patients (p<0.05). No minor or major complications were observed in this case series. Conclusions: It can be concluded that oxygen-ozone treatment is highly effective in relieving low back pain due to lumbar and lumbosacral disc prolapse. Keywords: Discogenic low back pain, Fluoroscopic, Minimally invasive, Ozone nucleolysis, Percutaneous 1 Department of Neurosurgery, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India 2 Department of Anaesthesia, Career Institute of Medical Sciences, Lucknow, Uttar Pradesh, India 3 Department of Neurosurgery, Maulana Azad Medical College and Associated G. B. Pant Hospital, New Delhi, India Received: 13 July 2016 Accepted: 13 August 2016 *Correspondence: Dr. Priyesh Bhaskar, E-mail: priyesh.bhaskar@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20163580