Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study

Francisco Nêuton de Oliveira Magalhães, Sandra Correia Soares, Jaqueline Melo Torres, Arthur Ungaretti, Mariana Fillipi Cacciacarro, Manoel Jacobsen Teixeira, Erich Talamoni FonoffPain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, U...

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Autores principales:	Magalh&atilde;es FNO, Soares SC, Torres JM, Ungaretti A, Cacciacarro MF, Teixeira MJ, Fonoff ET
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f856191ad05b4199b6feb2b001ff1a3b
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spelling	oai:doaj.org-article:f856191ad05b4199b6feb2b001ff1a3b2021-12-02T01:36:04ZEffects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study1176-63281178-2021https://doaj.org/article/f856191ad05b4199b6feb2b001ff1a3b2013-11-01T00:00:00Zhttp://www.dovepress.com/effects-of-ozone-applied-by-spinal-endoscopy-in-patients-with-chronic--a14962https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Francisco Nêuton de Oliveira Magalhães, Sandra Correia Soares, Jaqueline Melo Torres, Arthur Ungaretti, Mariana Fillipi Cacciacarro, Manoel Jacobsen Teixeira, Erich Talamoni FonoffPain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, BrazilIntroduction: In the last two decades, ozone has emerged as a treatment for low back pain, applied by means of minimally invasive techniques. Objective: The aim of this study is to assess the effect and safety of ozone therapy applied in the epidural space for chronic pain related to failed back surgery syndrome.Methods: The investigators studied 13 sequential patients of both sexes, between 18 and 70 years old, with persistent chronic pain (more than six months) in the lumbar region and in the lower limbs related to failed back surgery syndrome (FBSS). Pain was classified as neuropathic and non-neuropathic regarding the topography (lumbar and lower limb), based on the DN4 questionnaire. The patients received the ozone gas in the lumbar epidural space via spinal-sacral endoscopy. Clinical evaluation was performed before, immediately after (24 hours), and 1, 3, and 6 months after intervention with visual analog scale and Oswestry Disability Index (ODI).Results: Overall, the patients had 43.7% reduction of lumbar pain, 60.9% reduction in leg pain in six months followed by 44.0% of improvement in ODI. The reduction of pain and in the disability index was markedly greater in patients with non-neuropathic predominant pain, 95.2%, 80.6%, and 75.3% improvement in lumbar, leg pain, and ODI respectively, while neuropathic predominant pain patients experienced only 12.5%, 42.4%, and 20.9% improvement, also respectively. No neurological or infectious complications were observed acutely or during the follow-up. The present data suggests that epidural ozone might be a therapeutic option for persistent low back pain, especially in non-neuropathic predominant pain patients, but double-blind controlled studies are still required to prove its efficacy.Keywords: pain, failed back surgery syndrome, neuropathic pain, epiduroscopy, spinal endoscopy, ozone, minimally invasive surgeryMagalh&atilde;es FNOSoares SCTorres JMUngaretti ACacciacarro MFTeixeira MJFonoff ETDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 1759-1766 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Magalh&atilde;es FNO Soares SC Torres JM Ungaretti A Cacciacarro MF Teixeira MJ Fonoff ET Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
description	Francisco Nêuton de Oliveira Magalhães, Sandra Correia Soares, Jaqueline Melo Torres, Arthur Ungaretti, Mariana Fillipi Cacciacarro, Manoel Jacobsen Teixeira, Erich Talamoni FonoffPain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, BrazilIntroduction: In the last two decades, ozone has emerged as a treatment for low back pain, applied by means of minimally invasive techniques. Objective: The aim of this study is to assess the effect and safety of ozone therapy applied in the epidural space for chronic pain related to failed back surgery syndrome.Methods: The investigators studied 13 sequential patients of both sexes, between 18 and 70 years old, with persistent chronic pain (more than six months) in the lumbar region and in the lower limbs related to failed back surgery syndrome (FBSS). Pain was classified as neuropathic and non-neuropathic regarding the topography (lumbar and lower limb), based on the DN4 questionnaire. The patients received the ozone gas in the lumbar epidural space via spinal-sacral endoscopy. Clinical evaluation was performed before, immediately after (24 hours), and 1, 3, and 6 months after intervention with visual analog scale and Oswestry Disability Index (ODI).Results: Overall, the patients had 43.7% reduction of lumbar pain, 60.9% reduction in leg pain in six months followed by 44.0% of improvement in ODI. The reduction of pain and in the disability index was markedly greater in patients with non-neuropathic predominant pain, 95.2%, 80.6%, and 75.3% improvement in lumbar, leg pain, and ODI respectively, while neuropathic predominant pain patients experienced only 12.5%, 42.4%, and 20.9% improvement, also respectively. No neurological or infectious complications were observed acutely or during the follow-up. The present data suggests that epidural ozone might be a therapeutic option for persistent low back pain, especially in non-neuropathic predominant pain patients, but double-blind controlled studies are still required to prove its efficacy.Keywords: pain, failed back surgery syndrome, neuropathic pain, epiduroscopy, spinal endoscopy, ozone, minimally invasive surgery
format	article
author	Magalh&atilde;es FNO Soares SC Torres JM Ungaretti A Cacciacarro MF Teixeira MJ Fonoff ET
author_facet	Magalh&atilde;es FNO Soares SC Torres JM Ungaretti A Cacciacarro MF Teixeira MJ Fonoff ET
author_sort	Magalh&atilde;es FNO
title	Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
title_short	Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
title_full	Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
title_fullStr	Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
title_full_unstemmed	Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
title_sort	effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/f856191ad05b4199b6feb2b001ff1a3b
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Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study

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