Ozone neucleolysis or ozone discectomy is a non-operative intervention for slipped disc / disc prolapse & discogenic pain. Ozone discectomy is a day care procedure and general anaesthesia is not required. Total cost of the procedure is much less and is very safe compared to other procedures. It has been implicated as one of the important cause of low back pain radiating to limbs. Apart from conservative therapy all other forms of treatment aim at decompressing the nerve roots. These can be done by taking the disc out by surgery or by decompressing the foremen and disc by different interventions. The various treatment options have confused clinicians due to significant failure rate associated with different kinds of surgeries as well as with different interventions.
Epidural steroid injection, transformational epidural decompressions has a high success rate (up to 85%) but chances of recurrences are there specially if these interventions are done at later stage. Chemonucleolysis using chymopa pain has also high success rate (80%) with low recurrences but not popular owing to the chances of anaphylaxis following intradiscal chymopa pain injection. Injection of ozone for discogenic radiculopathy (low back pain with radiation to legs) has developed as an alternative to chemonucleolysis and disc surgery owing to its high success rate, less invasiveness, fewer chances of recurrences and remarkably fewer side effects.
How ozone acts?
The action of ozone is due to the active oxygen atom liberated from breaking down of ozone molecule. When ozone is injected into the disc the active oxygen atom called the singlet oxygen or the free radicle attaches with the proteo-glycan bridges in the jelly-like material or nucleus pulposus. They are broken down and they no longer capable of holding water. As a result disc shrinks and mummified and there is decompression of nerve roots. It is almost equivalent to surgical discectomy and so the procedure is called ozone discectomy or ozonucleolysis. Besides, it has an anti-inflammatory action due to inhibitions of formation of inflammation producing substances and tissue oxygenation is increased due to increased 2,3 diphosphoglycerate level in the red blood cells. All these leads to decompression of nerve roots, decreased inflammation of nerve roots, increased oxygenation to the diseased tissue for repair work.
Ozone nucleolysis or ozone discectomy has a success rate of about 80%. On the other hand surgical discectomy has much higher side effects compared to remarkably few side effects of ozone discectomy. Ozone discectomy is usually a day care procedure and general anaesthesia is not usually required. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to low cost, less hospital stay, no post-operative discomfort and morbidity and very few side effects.