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Albano D, Messina C, Gitto S, Fusco S, Sconfienza LM, Bellelli A. US/CT fusion imaging and virtual navigation to guide lumbar intradiscal oxygen-ozone therapy: a pilot study. J Ultrasound 2024; 27:291-296. [PMID: 38102520 PMCID: PMC11178682 DOI: 10.1007/s40477-023-00835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/02/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE To test the feasibility of US/CT fusion imaging to guide lumbar intradiscal O2/O3 therapy to treat discogenic degenerative low back pain due to lumbar disc herniation (LDH). METHODS We retrospectively included consecutive patients affected by low back pain and/or sciatica due to LDH resistant to conservative therapies, who underwent to lumbar intradiscal O2/O3 injection under CT/US fusion imaging guidance (Fusion Group) and standard CT guidance (Control Group). For each procedure, we collected procedure operative time, room utilization time, number of CT passes, complications, and O2/O3 intradiscal diffusion adequacy. Technical success was defined as the ability to complete the procedure as initially planned to reach the disc. Technical efficacy was based on O2/O3 intradiscal diffusion adequacy, as demonstrated by the last CT scan. RESULTS Six patients (4 males; mean age: 68 ± 15 years) were included in the Fusion group, six (4 males; mean age: 66 ± 12 years) in Control group. No complications were observed in both groups. In Fusion group we found significantly lower room utilization time (30 ± 6 min vs. 46 ± 10 min, p = 0.008), procedure operative time (14 ± 3 min vs. 24 ± 6 min, p = 0.008), and number of CT passes (2 [2,2] vs. 3 [3,3], p = 0.006) than in Control Group, respectively. Technical success and efficacy were 100% in both Groups. CONCLUSION CT/US fusion imaging seems to be a feasible and safe guidance for intradiscal O2/O3 injections, allowing decrease of procedure time and number of CT passes.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, Milan, Italy.
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy
| | - Stefano Fusco
- Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy
| | - Alberto Bellelli
- Unità Operativa Complessa di Radiologia Diagnostica ed Interventistica, Ospedale Fatebenefratelli San Pietro, Rome, Italy
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Somma F, Negro A, Tortora M, Gemini L, Pace G, Fasano F, Piscitelli V, Sicignano C, Prudente M, Falco AD, Villa A, Lugarà M, Pezzullo G, D'Agostino V, Gatta G. Sex life and low back pain: The impact of intradiscal ozone therapy in patients with herniated lumbar disc. Interv Neuroradiol 2023:15910199231183108. [PMID: 37321647 DOI: 10.1177/15910199231183108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To assess the improvement of sexual impairment after percutaneous intradiscal ozone therapy in patients complaining of low back pain (LBP) due to lumbar disc herniation. METHODS Between January 2018 and June 2021, 157 consecutive imaging-guided percutaneous intradiscal ozone therapies were performed on 122 patients with LBP and/or sciatic pain due to lumbar disc herniation. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-ups and the ODI Section 8 (ODI-8/sex life) values were retrospectively reviewed to evaluate the improvement of sexual impairment and disability. RESULTS Mean age of patients was 54.63 ± 12.40. Technical success was achieved in all cases (157/157). Clinical success was registered in 61.97% (88/142) of patients at 1-month follow-up and in 82.69% (116/142) at 3-month follow-up. The mean ODI-8/sex life was 3.73 ± 1.29 before the procedure, 1.71 ± 1.37 at 1-month follow up and 0.44 ± 0.63 at 3-month follow-up. Compared to older patients, subjects under 50 years showed a significantly slower recovery of sexual impairment (p = 0.003). The treated levels were L3-L4, L4-L5, and L5-S1 in 4, 116, and 37 patients, respectively. Patients with L3-L4 disc herniation showed less sexual disability at presentation, with a significantly faster improvement of sexual life (p = 0.03). CONCLUSIONS Percutaneous intradiscal ozone therapy is highly effective in reducing sexual impairment due to lumbar disc herniation, and the improvement is faster in older patients and in the case of L3-L4 disc involvement.
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Affiliation(s)
- Francesco Somma
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alberto Negro
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mario Tortora
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Laura Gemini
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Gianvito Pace
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Fabrizio Fasano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Valeria Piscitelli
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Carmine Sicignano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mariaevelina Prudente
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Arturo De Falco
- Neurology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alessandro Villa
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Marina Lugarà
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Giovanna Pezzullo
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Vincenzo D'Agostino
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Gianluca Gatta
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Caserta, Italia
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Somma F, Negro A, D’Agostino V, Piscitelli V, Pace G, Tortora M, Tortora F, Gatta G, Caranci F. COVID-19 and low back pain: previous infections lengthen recovery time after intradiscal ozone therapy in patients with herniated lumbar disc. Radiol Med 2022; 127:673-680. [PMID: 35536526 PMCID: PMC9088142 DOI: 10.1007/s11547-022-01500-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/27/2022] [Indexed: 11/25/2022]
Abstract
Purpose To assess and compare the clinical effectiveness of percutaneous intradiscal ozone therapy in patients affected by lumbar disc herniation, with and without history of COVID-19 infection. Materials and Methods After the rising of COVID-19 pandemics in Italy, 47 consecutive percutaneous intradiscal ozone therapies were performed on patients with low back pain and/or sciatic pain due to lumbar disc herniation. Among these, 19 had suffered from COVID-19 and successively recovered with no residual symptoms, while the remaining 28 had not previously been affected by COVID-19 and were not convalescent. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-up in order to assess the clinical outcome. Results The two groups were similar in terms of patient age (p-value 0.54), treated levels (p-value 0.26) and pre-procedure ODI (p-value 0.33). Technical success was achieved in all cases. In patients previously affected by COVID-19, mean ODI decrease was 11.58 ± 9.51 (35.72%) at 1-month follow-up and 20.63 ± 9.87 (63.63%) at 3-month follow-up. In patients never affected by COVID-19, mean ODI decrease was 20.93 ± 10.53 (58.73%) at 1-month follow-up and 22.07 ± 11.36 (61.92%) at 3-month follow-up. Eventually, clinical success was registered in 84.21% (16/19) of patients with history of COVID-19 infection and in 85.71% (24/28) of patients with no history of COVID-19 infection. No major complication was registered. Conclusions In case of lumbar disc herniation treated with percutaneous intradiscal ozone therapy, patients previously affected by COVID-19 showed a significantly longer recovery time.
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Affiliation(s)
- Francesco Somma
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Alberto Negro
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Vincenzo D’Agostino
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Valeria Piscitelli
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Gianvito Pace
- ASL NA 1 Centro, UOC Neuroradiologia, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
| | - Mario Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, 80131 Naples, Italy
| | - Fabio Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, 80131 Naples, Italy
| | - Gianluca Gatta
- Dipartimento di Medicina di Precisione, Università Vanvitelli, Via de Crecchio, 80138 Naples, Italy
| | - Ferdinando Caranci
- Dipartimento di Medicina di Precisione, Università Vanvitelli, Via de Crecchio, 80138 Naples, Italy
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