Title: Ozone therapy in disc herniation as a valid treatment

Abstract:

Ozone (O 3 ) is an unstable allotropic form of oxygen that imparts an oxidizing activity with various biological components. Ozone reacted only with substances that contain double bonds, such as amino acids, peptides, proteins, nucleic acids, and primarily unsaturated fatty acids, which serve as the building blocks of cellular membranes; lipid biolayers and the lipoprotein complexes found in blood plasma. It can generate its immune-modulating, anti-inflammatory, antibacterial, virucidal, fungicidal, analgesic, and other properties depending on the therapeutic dose chosen. Ozone therapy has various therapeutic uses including topical applications for wound healing, treatment of periodontitis, cancer, AIDS, severe acute respiratory syndrome, neurodegenerative diseases and diabetic foot. Advantages of Ozone therapy includes that it acts as a disinfectant and prevents oxidative damage. Ozone therapy has disadvantage of being hazardous to skin cells and red blood cell clumping is lessened or eliminated by ozone. Ozone therapy is indicated in lumbar herniated disc. Lumbar herniated disc causes symptoms of sciatica and possible foot pain, numbness or weakness. The rationale for direct O2-O3 therapy is that the pain caused by low back pain with sciatica or cruralgia is due to nerve root compression with bulging or herniated discs. Ozone is administered in the form of an oxygen-ozone gas mixture, at nontoxic concentrations varying from 1 to 40 μg of ozone per milliliter of oxygen. The optimal concentration of ozone per milliliter of oxygen for intradiscal administration is 27μg. Several clinical studies on the efficacy of the use of O2-O3 in treatment of lumbar disc herniations have been reported in the literature. In cervical disc herniation, nucleus pulposus of the intervertebral disc shifts at the cervical level which may directly compress the spinal cord or entrap nerve roots. Various clinical trials have demonstrated the effectiveness of O2 -O3 therapy in treatment of cervical disc herniation. Patients with neck pain and or radiculopathy corresponding to disc herniation without cervical cord compression are most suitable for ozone therapy. Ozone therapy is a minimally invasive treatment that provides antiinflammatory effects and pain relief by oxidizing proteoglycan in the nucleus pulposus leading to shrinkage of the disc which compresses the nerve roots. Studies have hypothesized that the injection of O3 induces overexpression of antioxidant enzymes which then neutralizes excessive ROS formation. A powerful stimulus to the activation of antioxidant defense is the result of O3 injected in the peridural space of the conjugation foramen and disc. Injections given in the cases that had extruded cervical disc pathology, good results were observed.

Biography:

Professor Massimo Piracci completed his MBBS from Roma Tor Vergata, Italy in 1992 and subsequently received his MD in Orthopedic and Traumatology from the same University in 1999. He was trained in Orthopedic Surgery in Roma Saint Eugenio Hospital and in Latina Santa Maria Goretti Hospital. From 2003 was HOD in Orthopedic and Traumatology Department in Roma Clinic Annunziatella where he did more than 10.000 surgery. He was also Football Referee for FIGC for 15 years and also external orthopedic consultant for different football team. From 2014 in UAE in AL Salama Hospital and  Universal Hospital, Abu Dhabi. He already treated for ACL reconstruction the goal keeper of Al Jazeera Football Club of Abu Dhabi. He uses the most advanced technologies and biological implant (PRP, Stamina cells, Ozone Therapy) and mini invasive surgery of hip head. He treats the most of orthopedic pathology for children and adults, the most of minor and major trauma, and sport injury with advanced mini invasive technique. For low back pain he uses the treatment with Ozone therapy that resolve the pain giving back a normal life to the patient.