PURPOSE: To elucidate the mechanism of action of intradiscal oxygen-ozone therapy for herniated intervertebral disc therapy. METHODS: Ozone's mechanism of action was investigated using 3 approaches: mathematical models of intervertebral disc space to explore the relationship between disc pressure and volume; ozonolysis experiments using glycosaminoglycans (GAGs) from a Chinese hamster ovary cell line that were similar in composition to GAGs found in human nucleus pulposus; and experiments in which live Yucatan miniature pigs received various concentrations of percutaneous, image-guided intradiscal oxygen-ozone treatment and were examined (after sacrifice) with histology and semiquantitative analysis of disc cytokine concentrations. RESULTS: Engineering calculations support observations that a small (6%) disc volume reduction can result in considerable (9.84%) intradiscal pressure reduction. Porcine disc histology and Chinese hamster ovary GAG ozonolysis results showed that administered ozone reacted with and fragmented disc proteoglycans, reducing disc volume through disc dehydration. Cytokine analysis of porcine discs found that each of 4 cytokines measured (interleukin [IL]-1β, IL-6, IL-8, and tumor necrosis factor α) increased in concentration after 2 wt% ozone treatment. CONCLUSIONS: Oxygen-ozone therapy breaks down proteoglycan GAGs that maintain disc osmotic pressure, dehydrating the nucleus pulposus and reducing intervertebral disc volume. This is likely a primary mechanism by which ozone relieves nerve root compression and alleviates herniated disc-related pain. Additionally, 2 wt% ozone appears to interact with intradiscal cytokines, generating an antiinflammatory response that may contribute to symptom improvement.
PURPOSE: To elucidate the mechanism of action of intradiscal oxygen-ozone therapy for herniated intervertebral disc therapy. METHODS:Ozone's mechanism of action was investigated using 3 approaches: mathematical models of intervertebral disc space to explore the relationship between disc pressure and volume; ozonolysis experiments using glycosaminoglycans (GAGs) from a Chinese hamster ovary cell line that were similar in composition to GAGs found in human nucleus pulposus; and experiments in which live Yucatan miniature pigs received various concentrations of percutaneous, image-guided intradiscal oxygen-ozone treatment and were examined (after sacrifice) with histology and semiquantitative analysis of disc cytokine concentrations. RESULTS: Engineering calculations support observations that a small (6%) disc volume reduction can result in considerable (9.84%) intradiscal pressure reduction. Porcine disc histology and Chinese hamster ovary GAG ozonolysis results showed that administered ozone reacted with and fragmented disc proteoglycans, reducing disc volume through disc dehydration. Cytokine analysis of porcine discs found that each of 4 cytokines measured (interleukin [IL]-1β, IL-6, IL-8, and tumor necrosis factor α) increased in concentration after 2 wt% ozone treatment. CONCLUSIONS:Oxygen-ozone therapy breaks down proteoglycan GAGs that maintain disc osmotic pressure, dehydrating the nucleus pulposus and reducing intervertebral disc volume. This is likely a primary mechanism by which ozone relieves nerve root compression and alleviates herniated disc-related pain. Additionally, 2 wt% ozone appears to interact with intradiscal cytokines, generating an antiinflammatory response that may contribute to symptom improvement.
Authors: Federico Bruno; Nicola Carboni; Pierpaolo Palumbo; Francesco Arrigoni; Marco Varrassi; Antonio Izzo; Nadia Catallo; Ernesto Di Cesare; Carlo Masciocchi; Alessandra Splendiani; Andrea Giovagnoni; Antonio Barile Journal: Interv Neuroradiol Date: 2021-09-13 Impact factor: 1.764
Authors: Javad Javadi Hedayatabad; Amir R Kachooei; Negar Taher Chaharjouy; Niloufar Vaziri; Hassan Mehrad-Majd; Maryam Emadzadeh; Mansour Abolghasemian; Mohammad H Ebrahimzadeh Journal: Arch Bone Jt Surg Date: 2020-05
Authors: Mohamed Ezeldin; Marco Leonardi; Ciro Princiotta; Massimo Dall'olio; Mohammed Tharwat; Mohammed Zaki; Mohamed E Abdel-Wanis; Luigi Cirillo Journal: Neuroradiology Date: 2018-09-11 Impact factor: 2.804