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A comparison of intradiscal ozone with transforaminal triamcinolone and bupivacaine to ozone therapy alone in the treatment of discogenic sciatica
Kawsar Sardar1, M Omar Faruque2, Gautam Das3, Richard Hubbard4, Nicholas C H Liang5, Harvey Finkelstein6, Pankaj N Surange7, Geeta Joshi8
1 Associate Professor and Pain Consultant, Department of Anesthesiology, BIRDEM General Hospital and Ibrahim Medical College, Shahbag, Dhaka, Bangladesh
2 Associate Professor, Department of Nutrition and Food Engineering, Daffodil International University, Dhaka, Bangladesh
3 Director, Department of Pain Medicine, Daradia: The Pain Clinic, Kolkata, India
4 Resident Anesthesiologist, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
5 Senior Consultant and Director, Department of Anaesthesiology and Pain Medicine, Specialist Pain International Clinic, Mt Elizabeth Hospital, Singapore, Singapore
6 Director Emeritus, Department of Anaesthesiology and Pain Medicine, Pain Care Medicine of Long Island, New York, USA
7 Director and Chairman, Department of Anaesthesiology and Pain Medicine, Interventional Pain and Spine Centre, New Delhi, India
8 Professor, Department of Anaesthesiology, Pain and Palliative Medicine Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
Correspondence Address:
Kawsar Sardar
Associate Professor and Pain Consultant, Department of Anesthesiology, BIRDEM General Hospital and Ibrahim Medical College, Shahbag, Dhaka, Bangladesh
Bangladesh
 Source of Support: None, Conflict of Interest: None  | 20 |
DOI: 10.5005/jp-journals-10046-0047
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Introduction: Ozone disk nucleolysis is a nonsurgical percutaneous procedure for the treatment of discogenic sciatica, and published success rates of ozone disk nucleolysis vary significantly. This study assesses the outcome difference between two treatment modalities among patients with discogenic sciatica secondary to a herniated disk in Bangladesh: Intradiscal ozone injection and combination therapy with intradiscal ozone and transforaminal triamcinolone and bupivacaine injection.
Materials and methods: Prospectively recruited 50 patients (group I) received intradiscal injections of an oxygen–ozone mixture and 150 patients (group II) received identical oxygen–ozone injections, followed by transforaminal triamcinolone 20 mg in 2 mL of 0.25% bupivacaine, in relevant foramen. Discography was noted for each case. All patients underwent follow-up examinations at 1-week, 1-month, and 6-month time points. Clinical outcome was evaluated by using the verbal rating scale (VRS) and modified Macnab method.
Results: According to the modified Macnab method, group II showed “excellent and good” result of about 97, 90, and 88% in 1-week, 1-month and 6-month time points respectively, whereas group I showed 70, 70, and 68% at the same time point. The difference is significant in each time point. Groups I and II demonstrated similar VRS scores prior to intervention,but patients in group II had significantly better VRS pain scores at all three time points.
Conclusion: A combination of transforaminal triamcinolone and local anesthetic with intradiscal ozone provides clearly superior outcomes when compared with ozone therapy alone in discogenic sciatica.
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