Predictive factors of volumetric reduction in lumbar disc herniation treated by O2-O3 chemiodiscolysis

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Alberto Negro
Aldo Paolucci
Camilla Russo
Martina Di Stasi
Pasquale Guerriero
Francesco Arrigoni
Federico Bruno
Francesco Pagnini
Salvatore Alessio Angileri
Pierpaolo Palumbo
Carlo Masciocchi
Gianfranco Puoti
Fabio Tortora
Ferdinando Caranci


Lumbar Disc Herniation; Magnetic Resonance Imaging; Chemiodiscolysis; Minimally Invasive Surgery; Oxygen-Ozone Therapy.


Purpose: Aim of this study is to assess the effectiveness of O2-O3 percutaneous chemiodiscolysis by evaluating volumetric changes in lumbar disc herniation on magnetic resonance imaging, in order to identify possible pre-treatment factors affecting such changes Methods: Between January 2014 and December 2017, a total of 87 patients with low back pain and 103 lumbar disc herniations with MRI confirmation were considered for O2-O3 chemiodiscolysis. The volume of each herniated disc was determined before and after the treatment. Results:  Multiple linear regression analysis showed a strong correlation between post-treatment LDH volume percent change and both pre-treatment LDH volume and pre-treatment EQ-VAS (p<0.05), while age showed only a weak positive correlation with post-treatment LDH volume percent change (p<0.1). No association was found for other factors, such as sex and herniation disc level. Conclusions: In conclusion, age, baseline LDH volume and self-assessed disease severity score could represent three easy accessible outcome predictive parameters to consider when intradiscal O2-O3 chemiodiscolysis is envisaged. Better results after intradiscal O2-O3 chemiodiscolysis were obtained in older patients with higher pre-treatment LDH volume and low-moderate pre-treatment EQ-VAS.


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