Ozone Disc Injection For Treatment of Herniated Discs – (AKA – ozone nucleolysis, intradiscal ozone injections)

My Quest:

I herniated my lumbar disc at  L5-S1 approximately 5 years ago and found myself on a continuing quest to heal it. Over the last 5 years I’ve kept an eye on all the information I could find to fix it. Like most, I started with conservative therapy (rest, NSAIDS, and PT) which may have helped, but none of these fixed the problem. I did not want to have surgery. I waited for a new non-surgical approach to healing a herniated disc to emrge and in my research I came across something new – ozone disc injections. There is not much information about this procedure available, particularly the type of information I was looking for, which was first hand accounts from back pain sufferers who underwent the procedure. Most of the information available is in the form of scholarly articles. These are fine, but can be difficult to interpret and the studies are not blinded. Well folks, I researched everything I could find, located a doctor who does this procedure in the United States, and underwent the procedure on 5/24/12. I am providing you with everything I’ve learned and the results from the procedure. Hopefully the next back pain sufferer looking for information on ozone disc injections for a herniated disc comes here first for a one stop shop. I need to make it clear that I have no affiliation with any doctors, ozone machine manufacturers, or anybody else that has anything to do with this process. Let’s get started.

My Diagnosis/Symptoms:

For reference purposes: Focused para midline (medium-sized) herniated disc abutting nerve root at L5-S1 confirmed on MRI. Low back pain, left butt pain, off-and-on radiculopathy in parts of left leg and foot. Difficulty sitting for long periods of time. Height 5’8″ Weight 150lbs. Age 36. Symptoms present for approximately 5 years.

What is An Ozone Disc Injection?

It is an injection of oxygen and ozone used to treat a herniated disc. There are two types: one is an injection outside of the disc and one is an injection directly into the disc. The one that “everybody is talking about” is the one directly into the disc. The procedure that I had was the one directly into the disc, therefore that is what I am reporting on.The theory is that the free radical (the 3rd O in the O3) in the ozone reacts with the inner disc material in a positive way and reduces inflammation and shrinks the disc and thus the hernia. I say it this way because the exact mechanism of this “positive effect” has not been fully defined (read the scholarly articles for more on this – there are several theories on why/how it works – I’m not qualified to give an opinion on this).

How is the procedure done?

It is an outpatient procedure performed using a local anesthesia and twilight anesthesia. A needle is guided to your disc under fluoroscopic (live x-ray) guidance and a mixture of oxygen and ozone is injected directly into your herniated disc. The procedure is identical to a discogram, except O2/O3 is injected instead of dye. If you’ve had a transforaminal epidural steroid injection, the procedure seemed similar to me, although the needle takes a different route and the O2/O3 is injected into a different place. The procedure was painless (I was unconscious) and when I woke up I still had the local anesthesia working so I was in no pain. Afterwards you must lie on your back (or either side) for 6 hours at the surgery center to keep pressure off the disc and keep the ozone from leaking out while it “reacts” with your inner disc material. I was unable to lie on my back for 6 hours because I had to urinate. I discovered that I (or maybe men in general) cannot urinate while lying down (yes, even leaning way over on my side). I did make it 3 hours and the doctor said it was not a big deal to get up and urinate quickly. Be prepared for this, my back teeth were floating! You need somebody to drive you home. I was groggy, but wasn’t in much pain. Afterwards, I took it easy and waited to see what happened. I flew out of state for this and had to drive to the airport and board a plane the next day, neither of which was a problem. There was slight pain at the injection site.

Tell Us About The Results Already!

The information available states that some results show in 3-7 days. My doctor told me to wait 2 weeks to expect significant results. The scholarly articles report results at 2 weeks, 6 months, 12 months, and 18 months. None of the scholarly articles that I found except for the one with the 5 dogs gave a specific recovery time for maximum results after the procedure. That article stated a maximum of 12 days for disc shrinkage to occur.

Here are my results so far (10 days in). The first noticeable effect, about 3 days after the procedure, was what I would define as a “free-up” of the area in my low back that I was used to always “protecting”. Normally this area felt like the hernia was rubbing the nerve when I sat or did anything with a forward lean. Sitting was noticeably more tolerable. There was, however, an increase in some leg symptoms, but the new leg symptoms were different than my old leg symptoms (more of a burning sensation and sometimes in different locations than normal). I hope that these symptoms are signs that the nerve is healing. I had a “very deep” left butt pain as well that I’ve not experienced before about 6 days in. Left butt pain was one of my normal symptoms, but this was different. This subsided, but I still have something going on in the left leg. I know these aren’t the most exciting results, but it has only been 10 days and the low back “free-up” is still noticeable. So folks, I wouldn’t expect an instant miracle. The literature does suggest that the disc shrinks over time, so that is what I am hoping for. I will continue to report my results here as time goes on. I do think that something positive is happening and there is definitely something different going on down there than before. The “freed-up” back is a nice feeling.

Some STuff You’ll Want To Know

Cost: $2,500 – Not covered by insurance at all.

This procedure was performed by a real MD in a real hospital (this was, of course, very important to me). He’s experienced working with discs and has performed thousands of discograms (identical procedure) and several (not sure how many – probably less than 50) of these.

This procedure is not FDA approved and done only on an experimental basis in the US.

You need an MRI report and the images for this procedure.

From everything I’ve read, the full effect takes place over time (6 months or so). One of the articles gives data comparing microdiscectomy to ozone injection for herniated disc and at 6 months and beyond, the results are more or less equal. The article with the most information on results is (somewhat surprisingly) the dog article. They injected the discs of 5 dogs and followed their progress by watching their symptoms disappear and doing CT scans to objectively evaluate disc/hernia shrinkage. All of their discs and hernias decreased in volume, the maximum amount of time being 12 days. The dogs improvement was evident on both the CT scans and their observed physical improvement (without regression up to 20 months – when they stopped monitoring them). The other articles have various numbers of subjects and the outcomes listed in the way scholarly articles usually list them. There are no answers to open ended questions, just pain scale results. My calculated guess, after reading the articles, is that the success rate of this procedure on an ideal candidate is somewhere around 75%-80%. An ideal candidate has a contained, soft, herniated disc at one level. Multiple level injections have been successful according to the articles.

I’m not a doctor, but I’m a thorough researcher. I want to give people hope, but don’t want to give false expectations so heed the following:

The dog article states that the higher the level of calcification of the disc, the less it shrinks with this procedure. Therefore, you will get the most shrinkage with a soft herniated disc.

You need to know that if you have hardware or have undergone invasive surgery that this may not work for you. This is something you’ll need to talk to the doctor about.

Where are these articles you keep talking about?

Dog Article

Results at 5 Years Article

Muto Article (Italian doctor everybody is talking about)

Society of Interventional Radiology Article

Google this and you’ll find quite a few more (try Google Scholar).

Disclaimer:

I am not a doctor and I do not claim to be a doctor. This is not medical advice in any way, shape, or form. This is an information only report on the topic of intradiscal ozone injections for treatment of a herniated disc and contains my personal results from the treatment. Consult a qualified medical doctor for medical opinions on this topic.

Categories: Research
post | Comments Off June 4, 2012

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