The principle and advantages of ozone therapy for intervertebral discs



1、 There are two main reasons for lumbar and leg pain caused by intervertebral disc herniation: mechanical compression of nerves, aseptic inflammation of nerve roots, nutritional disorders of nerve roots, and damage to nerve root conductivity. At present, it is believed that the mechanism of action of injecting medical ozone into and out of the lumbar disc for the treatment of lumbar disc herniation is mainly as follows:
① Oxidized proteoglycans: This is the main mechanism of medical ozone therapy for lumbar disc herniation. The normal nucleus pulposus is composed of proteoglycans, collagen fiber network, and nucleus pulposus cells. Proteoglycans are one of the most important macromolecular structures in the nucleus pulposus, which can absorb charges into the nucleus pulposus matrix and generate high osmotic pressure. They are the main factor contributing to the nucleus pulposus water content reaching up to 85%. The characteristic of losing fixed charge density after proteoglycans are destroyed. The decrease in osmotic pressure of the nucleus pulposus matrix ultimately leads to water loss and atrophy, and the volume of the nucleus pulposus shrinks, thereby reducing the pressure inside the intervertebral disc and eliminating symptoms, achieving the goal of treatment. However, medical ozone has a weaker effect on the cartilage endplate and annulus fibrosus. The pathological results of animal experiments conducted by Yu Zhijian and He Xiaofeng showed that the ultimate effect of medical ozone on normal nucleus pulposus was a decrease in water content, resulting in a reduction in nucleus pulposus volume and pressure; The gross specimen shows that the nucleus pulposus loses elasticity, changes color, and dries up. When the intervertebral disc is cut open, the nucleus pulposus does not expand outward; Under electron microscopy, the large vesicular structures within the nucleus pulposus matrix disappear.
② Destruction of nucleus pulposus cells: Iliakis et al. confirmed that medical ozone injection into nucleus pulposus tissue can cause degeneration of nucleus pulposus cells in the early stages, followed by cell necrosis and dissolution. Damage to the nucleus pulposus cells inevitably leads to reduced synthesis and secretion of proteoglycans.
③ Anti inflammatory effect: The prominent nucleus pulposus and annulus fibrosus compress the dura mater, nerve roots, and surrounding veins, causing reflux disorders, exudation, and tissue edema; The nucleus pulposus tissue has strong irritability and releases a large amount of histamine upon contact with nerve roots, causing chemical inflammation of the spinal nerve roots; The glycoproteins and beta proteins released after the rupture of the fibrous ring act as antigenic substances, triggering an immune response in the body. Research shows that medical ozone neutralizes excessive reactive oxygen species in inflammatory reactions by stimulating the overexpression of antioxidant enzymes; Stimulate the release of cytokines and/or immunosuppressive cytokines (such as IL-10, TGF - β) that stimulate anti-inflammatory responses; Stimulating endothelial cells to release nitric oxide (N0) and platelet-derived growth factor (PDGF) can cause vasodilation, improve reflux, alleviate edema around nerve roots, and promote inflammation absorption.
④ Analgesic effect: Small nerve fibers and nerve terminal receptors are widely distributed on the surface of lumbar facet joints, intervertebral discs, and adjacent ligament attachment points; Neuroreceptors are activated by mechanical stimuli such as locally felt pressure and traction, or by inflammatory factors and chemical substances released by the protruding nucleus pulposus (such as substance P or phosphatase A2), which increase sensitivity and cause reflexive muscle spasms leading to lower back pain and/or sciatica. Therefore, medical ozone causes atrophy of the nucleus pulposus, reduces nerve root pressure, and alleviates inflammatory reactions. Bocci E also speculated that the analgesic effect of medical ozone injection with fine needle in the treatment of lumbar disc herniation may be a mechanism similar to "chemical acupuncture and moxibustion", that is, inhibiting the unmyelinated damage receptor fibers, and stimulating the inhibitory interneurons to release enkephalin to relieve pain by activating the inhibition mechanism of pain perception.
2、 Advantages of medical ozone therapy:
① The advantages of traditional minimally invasive treatment methods for lumbar disc herniation include minimal surgical trauma, no damage to the normal bony structure of the spine, no disruption to spinal stability, fewer complications, precise results, less patient pain, faster recovery, and shorter hospital stay.
② Ozone easily decomposes to form stable oxygen. Therefore, it will not cause secondary pollution and persistent organ and tissue damage or residue in the body;
③ Ozone has a strong destructive ability on nucleus pulposus tissue (selectively acting on proteoglycans within the nucleus pulposus), but has no significant adverse effects on paraspinal tissue; Small doses of high concentration ozone entering the subarachnoid space by mistake will not cause significant damage to the spinal cord.
④ High security. CT or C-arm guided fine needle aspiration surgery with accurate positioning.
⑤ The surgical method is simple to operate, with low instrument requirements. Simple nucleus pulposus ablation surgery can be completed in 10-30 minutes; Intra articular injection and pain point injection can be performed in the outpatient department:
⑥ Medical ozone has disinfection and sterilization effects, which can greatly reduce the incidence of postoperative intervertebral disc infection. It also has a certain therapeutic effect on the surgical failure syndrome that occurs after surgical treatment of lumbar disc herniation.
⑦ Selective oxidation of nucleus pulposus tissue reduces intervertebral disc pressure, while injecting ozone into the intervertebral space has anti-inflammatory and analgesic effects, providing a dual treatment for symptoms caused by intervertebral disc herniation.
⑧ Ozone has a low price, reducing surgical costs;
⑨ Suitable for a wide range of people, especially those who are unwilling to undergo surgical treatment and elderly people who are weak and intolerant to surgery. There is also a certain therapeutic effect on the surgical failure syndrome that occurs after surgical treatment of lumbar disc herniation.




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