Thomas Lehnert MD, Presenter: Nothing to Disclose

Nagy N. N. Naguib MSc, Abstract Co-Author: Nothing to Disclose

Nour-Eldin Abdelrehim Nour-Eldin MSc,MD, Abstract Co-Author: Nothing to Disclose

Sebastian Lindemayr, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, Abstract Co-Author: Nothing to Disclose

To evaluate the therapeutic benefit and morphologic changes in herniated cervical disk after CT-guided intradiscal and periganglionic ozone-oxygen injection combined with a periganglionic administration of steroids and anesthetic.

120 patients with cervical radiculopathy received an intradiscal (3 mL) and periganglionic (7 mL) injection of an ozone-oxygen mixture (ratio 3:97), followed by a periganglionic injection of corticosteroid (1 mL of Celestan®Depot, ESSEX PHARMA, Munich, Germany) and anesthetic (2 mL of Carbostesin® 0.25%, AstraZeneca, Wedel, Germany) in the same session. Under CT guidance, intradiscal and periganglionic injection was administered by means of an extraspinal lateral approach, using a 22-gauge 17.8-cm spinal needle (Becton Dickinson & Co, Franklin Lakes, NJ, USA). 6 months after treatment, clinical outcome was assessed by applying the modified MacNab method.

Treatment was successful in 86 patients (71.7%). In the remaining 34 patients (28.3%), treatment was considered to have failed. Among the patients whose treatment was a success, outcome was excellent in 47 patients (54.7%) and good in 39 patients (45.3%). Among the patients whose treatment was a failure, this was poor in 27 patients (79.4%) and poor with recourse to surgery in 7 patients (20.6%). Complications occurred in 11 patients (9.2%), who presented with episodes of impaired sensitivity in the upper limb ipsilateral to the treatment; the episode resolved spontaneously within 2 hours.

Our study shows that the combined intradiscal and periganglionic injection of medical ozone and periganglionic injection of steroids affects both the mechanical and the inflammatory components of pain caused by disk herniation. For this reason, this is a therapy option for treating cervical disk herniation that has failed to respond to conservative management, before recourse to surgery or when surgery is not possible.

The ease of execution and non-invasiveness of this novel therapy permit the successful outpatient treatment of cervical disk herniation.

Lehnert, T, Naguib, N, Nour-Eldin, N, Lindemayr, S, Vogl, T, Final Results of Intradiscal Injection of Oxygen Ozone Mixture for the Treatment of Cervical Disk Herniations: Effects on Disk Size and Cervical Radiculopathy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008120.html