Aclinical Study On The Percutaneous Puncture Disc Ozone Ablation

Objective It will evaluate the clinical effect of percutaneousintervertebral disc ozone ablation, safety, indication and contraindication,operation method, the optimum concentration of ozone and other issues,for lumbar disc herniation patients to find a safe and effective almostnoninvasive treatment.Method Analysis of the clinical data of the lumbar disc herniationpatients and the postoperative curative effect in the People’s Hospital ofYingde from January,2007to June,2013,which is the largestcounty-level city in Guangdong Province.Percutaneous disc herniationpatients take ozone ablation or conservative treatment, post-treatmentwith different concentrations of ozone injected into the intervertebral disc,postoperative follow-up, according to the modified MacNab method forefficacy evaluation.Result1、 Since January2007to December2011, the lumbar disc herniationpatients in the People’s Hospital of Yingde,462cases were collected, theozone in the intervention group (n=276) and the conservative treatmentgroup (n=186). The application of ozone ablation in the treatment oflumbar disc herniationpatients, preoperative CT or MRI examination todistinguish types, including66buldging,202protrusion and8extrusion. Among the Ozone intervention group (n=276), the outcome wasexcellentin74cases (26.8%), good in98cases (35.6%),effetively in36cases(13%), poor in68cases (24.7%), the total efficiency is75.4%；Amongthe conservative treatment group (n=186),5cases of excellent efficacy(13.4%),good in42cases (22.6%), effetively in39cases (21%), poor in80cases (43%), the total efficiency is57%；Compare with ozoneinterventional group and conservative treatment group, Chi-square test χ~2=17.23, P<0.000033,the difference has statistically significant.2、Since January2007to December2011, among the oflumbar protrusionof the intervertebral disc by ozone interventional treatment in the People’sHospital of Yingde,52effective cases out of66buldging cases,efficiency of81.8%, protrusion in202cases, effective154cases,efficiency of76.2%, out of extrusion8cases, effective2cases, efficiencyof25%. Compare with the three curative effect of respectively,Chi-square test χ~2=11.425and P<0.005,the difference has statisticallysignificant. Buldging vs Protrusion, χ~2=0.182and P>0.0125,thedifference has not statistically significant; Bulging vs Extrusion, χ~2=7.917and P<0.005,the difference has statistically significant; Protrusion vsExtrusion, χ~2=8.064and P<0.005,the difference has statisticallysignificant.3、Since January2012to June2013, patients in the People’s hospital ofYingde was used in treatment of different ozone concentration in theapplication.After one week on the efficacy follow-up, found thatintraoperative40ug/mL concentrations of ozone, the total efficiency of66.7%, intraoperative60ug/mL ozone, the total efficiency of82.5%, Thedifference has statistically significant in χ~2=4.189and P=0.041afterChi-square test;On the efficacy after1month follow-up, the application40ug/mL ozone concentration, efficiency69.8%, the concentration ofozone therapy applications60ug/mL, efficiency84.1%, χ~2=3.63andP=0.057, the difference has not statistically significant；On the efficacyfollow-up3months after the application40ug/mL concentrations ofozone, efficiency76.2%,60ug/mL concentration of ozone therapy,efficiency84.1%, χ~2=1.25and P=0.264, the difference has not statisticallysignificant.ConclusionPercutaneous disc ozone ablation is a safe and effectiveminimally invasive surgical approach, worthy of extensive in clinic. It issignificant curative effect in type of intervertebral disc buldging andprotrusion, but unsuitable for the treatment of intervertebral discextrusion type of patients. It can take40~60ug/mL of ozone concentrationinjected into the lumbar disc herniation.The higher concentration,short-term curative effect is better, but no effect on the long-term curativeeffect. Ozone can be used as a minimally invasive method alone in thetreatment of lumbar disc herniation, as well as synergistic treatment ofother minimally invasive method or operation. I Suggest to use feasible step therapy for the intervertebral disc protrusion, in proper order:conservative treatment, ozone treatment, operation treatment.