CT-guided ozone mixture injection in treatment of symptomatic lumbar facet synovial cysts

Main Article Content

Salvatore Masala https://orcid.org/0000-0003-0032-7970
Adriano Lacchè https://orcid.org/0000-0003-1782-8624
Fabio Salimei
Antonio Ursone
Vincenzo Pipitone
Federica Masino
Giuseppe Maria Andrea D'Arma
Giuseppe Guglielmi https://orcid.org/0000-0002-4325-8330

Keywords

Ozone injection; lumbar facet synovial cysts; radiculopathy; low-back pain.

Abstract

Background and aim: To evaluate the clinical and radiological outcomes, in terms of safety and efficacy, of a new treatment method for symptomatic lumbar facet synovial cysts (LFSC), based on ozone injection inside the cyst.


Methods: We retrospectively reviewed clinical records and imaging studies of 77 patients who underwent CT-guided ozone treatment of symptomatic facet joint synovial cysts in our department over a 5-year span.


Clinical outcome was assessed with Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) evaluations, obtained prior to the intervention and at 1-, 3-, 6- and 12-months follow-up.


Follow-up MRI imaging at 6 and 12 months were obtained and confronted with the pre-procedural MRI to analyse cyst modification after the intervention.


Results: Ozone administration was technically successful in 100% of procedures; no immediate complications occurred. At 1 month evaluation, 92% of the patients referred partial or complete symptomatic response; 86% of patients at 3 months and 84% at 6 months confirmed symptoms improvement; final assessment, at 12 months after intervention, outlined overall significant clinical improvement in 81% of patients. During the 12 months of follow-up only 3 patients had a relapse of the cyst (at 6 months) that were retreated with a 100% success.


Conclusions: CT-guided ozone therapy for symptomatic LFSC is a safe and innovative treatment option, with good clinical results at 12 months follow-up in a significative percentage of patients, thus reducing the need for invasive surgical interventions.

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