{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:41:26Z","timestamp":1787060486223,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>All percutaneous minimally invasive disc treatments are typically indicated to contained disc herniations. Our study\u2019s aim is to evaluate prospectively the efficacy of ozone nucleolysis in the treatment of either contained or uncontained lumbar disc herniations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifty-two patients, aged 27\u201387\u00a0years, with symptomatic herniated lumbar discs, without migration, sequestration, or severe degenerative disc changes, who failed conservative treatment, were included in our study. The patients underwent fluoroscopic-guided intradiscal oxygen-ozone mixture injection (5\u00a0ml) at a concentration of 27\u201330\u00a0\u03bcg\/ml and periradicular injection of the same O\n                      <jats:sub>2<\/jats:sub>\n                      -O\n                      <jats:sub>3<\/jats:sub>\n                      mixture (10\u00a0ml), steroid (1\u00a0ml), and local anesthetic (1\u00a0ml). Clinical outcomes were evaluated, based on the Oswestry Disability Index (ODI) and pain intensity (0\u20135) scale results, obtained initially and at 2- and 6-month controls. Our results were analyzed by ANOVA and chi-squared (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our initial results obtained at 2-month control were promising, indicating a significant decrease in pain disability and intensity in 74% (37) and 76% (38) of the patients respectively, and minimally increased to 76% (38) and 78% (39) at 6-month control (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 and CI 99.9%\n                      <jats:bold>)<\/jats:bold>\n                      . The mean preprocedure ODI and pain intensity scores were 35\u2009\u00b1\u200914.36 and 2.38\u2009\u00b1\u20090.90, respectively, which were reduced to 19.36\u2009\u00b1\u200913.12 and 1.04\u2009\u00b1\u20090.92 at 6-month control. Our failure had been mostly related to long symptoms duration of more than 1\u00a0year. No complications were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ozone nucleolysis is a safe cost-effective minimally invasive technique for treatment of contained and uncontained lumbar disc herniations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-018-2083-4","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T04:26:38Z","timestamp":1536639998000},"page":"1231-1241","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Percutaneous ozone nucleolysis for lumbar disc herniation"],"prefix":"10.1007","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5613-1729","authenticated-orcid":false,"given":"Mohamed","family":"Ezeldin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Leonardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Princiotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Dall\u2019olio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Tharwat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Zaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed E.","family":"Abdel-Wanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Cirillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"issue":"2","key":"2083_CR1","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1177\/197140090101400214","volume":"14","author":"L Simonetti","year":"2001","unstructured":"Simonetti L, Agati R, Cenni P, De Santis F, Leonardi M (2001) Mechanism of pain in disc disease. 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Affiliation 2 was presented incorrectly in the original article. The updated affiliation is Neuroradiology Unit, Bellaria Hospital, IRCCS Institute of Neurological Sciences, Bologna, Italy.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2019","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The published version of this article unfortunately contained a mistake. Affiliation 2 was presented incorrectly in the original article. The updated affiliation is Neuroradiology Unit, Bellaria Hospital, IRCCS Institute of Neurological Sciences, Bologna, Italy.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"No funding was received for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study is joint research work between IRCCS Institute and Bellaria Hospital, Bologna, Italy, and Sohag University Hospitals, Sohag, Egypt. The institutional ethics committee\u2019s approval for the study design was approved in Egypt. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}