• M Muto, G Ambrosanio, G Guarnieri, E Capobianco, G Piccolo, G Annunziata, and A Rotondo.
• U.O.C. Neuroradiologia A.O.R.N.A. Cardarelli Napoli, Napoli, Italy. mario.muto@ospedalecardarelli.it
• Radiol Med. 2008 Aug 1;113(5):695-706.

PurposeThis paper describes discolysis by intradiscal, periganglionic and periradicular oxygen-ozone (O(2)-O(3)) injection, a minimally invasive percutaneous technique for the treatment of lumbar disk herniation.Materials And MethodsFrom June 2000 to December 2006, we performed O(2)-O(3) chemonucleolysis procedures in 2,900 patients affected by lumbar disk herniation. Patients were selected on the basis of clinical, psychological, neurological and neuroradiological criteria. Exclusion criteria were extruded hernia and/or free disc fragments, hyperalgesic-paralysing sciatica and progressive neurological impairment of the affected limb. All percutaneous treatments were performed under computed tomography (CT) guidance. All patients were evaluated after 1 month, and those showing only partial success were scheduled for a second treatment session.ResultsResults were evaluated with the modified MacNab classification, the visual analogue scale and the Oswestry Disability Index at 6 and 12 months. Success rates were 75%-80% for soft disc herniation, 70% for multiple-disc herniations and 55% for failed back surgery syndrome. None of the patients suffered early or late neurological or infectious complications.ConclusionsAccording to our data, minimally invasive percutaneous treatment by intradiscal, periradicular or periganglionic O(2)-O(3) infiltration is a valuable and competitive technique that provides excellent results at low cost and without complications.

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