Ozone disc nucleolysis in the management of herniated lumbar intervertebral disc: A retrospective analysis
Sharad Balasaheb Ghatge1, Rohit Pannalal Shah2, Nirmal Surya3, Suresh Sankhala4, Chetan Jagjivandas Unadkat2, Gulam M Khan5, Dhaval B Modi6
1 Department of Radiology and Imaging, Division of Interventional Radiology, Grant Government Medical College and Sir JJ Group of Hospitals; Department of Interventional Neuroradiology, Bombay Hospital, Mumbai, Maharashtra, India
2 Department of Orthopedics, Breach Candy Hospital, Mumbai, Maharashtra, India
3 Department of Neurology, Bombay Hospital, Mumbai, Maharashtra, India
4 Department of Neurosurgery, Saifee Hospital, Mumbai, Maharashtra, India
5 Department of Neurosurgery, Global Hospital, Mumbai, Maharashtra, India
6 Department of Interventional Neuroradiology, Bombay Hospital, Mumbai, Maharashtra, India
Sharad Balasaheb Ghatge
Flat No. 19, Swastik Building No. 4, Sir JJ Hospital Campus, Sir JJ Road, Byculla, Mumbai - 400 008, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: Various minimally invasive surgeries were proposed for the management of herniated lumbar intervertebral disc. However, to choose optimal treatment modality to maximize patient benefit is a clinical challenge for the treatment givers.
Objective: The objective was to study the role of ozone disc nucleolysis in the management of herniated lumbar intervertebral disc by retrospective analysis.
Methodology: We conducted a retrospective analysis of patients of lumbar disc herniation treated by ozone disc nucleolysis during May 2007–May 2021. There were total of 2089 patients with 58% of males and 42% of females. The age ranged from 18 to 88 years. Outcome was measured on the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) along with modified MacNab method.
Results: The mean baseline VAS score was 7.73, which became 3.07 at 1 month, 1.44 at 3 months, 1.42 at 6 months, and 1.36 at 1 year. Similarly, the mean ODI index was 35.92 at baseline, which improved to 9.17 at 1 month, 6.14 at 3 months, 6.10 at 6 months, and 6.09 at 1 year. VAS score and ODI analysis was found to be statistically significant with P < 0.05. Modified MacNab criterion showed successful treatment outcome in 85.6% with excellent recovery in 1161 (55.58%), good recovery in 423 (20.25%), and fair recovery in 204 (9.77%). Mediocre or no recovery was seen in the remaining 301 patients amounting to a 14.40% failure rate.
Conclusion: This retrospective analysis confirms that ozone disc nucleolysis is an optimally effective and least invasive treatment option for herniated lumbar intervertebral disc with a significant reduction in disability.