ABSTRACT
Objective To evaluate the applied value of percutaneous oxygen-ozone injection in the treatment of lumbar disc herniation under open 0.23 T MRI guidance.Methods Mounted with ipath 200 optical tracking system,MR-guided injection of oxygen-ozone were performed via a medial border of the articular processes approach in 73 patients with clinically diagnosed LDH.MR compatible 19.5G or 21.0 G biopsy needle was used. Discography was performed in order to select indication before injection oxygen- ozone into nucleus pulposus in 26 patients.Sixty-four patients were injected to three sites:(1)Six to 10 ml oxygen-ozone was injected into discs centers,injected and suctioned alternately in order to make nucleus pulposus oxidation thoroughly.(2)The needle was withdrawn according to the scale of biopsy needle and optical tracking.Then,10 ml oxygen-ozone was injected into disc herniation. (3)After that,needle was withdrawn further about 1.0—1.5 cm to outside of annulus fibrosus.Fifteen to 20 ml oxygen-ozone was injected into intervertebral foramina around nerve roots.The oxygen-ozone concentration was 35—45?g/ml. Nine patients were only performed injection of oxygen-ozone into around nerve root,while not injection oxygen-ozone to nucleus pulposus for considering bad curative effect after discography.Results All of 73 patients were successfully local targeted and treated under MRI guidance without serious complications, such as nerve root injury.After 3—6 months follow-up,total overall efficacy was 91.3% with the excellent in 28,good in 39,and poor in 6,respectively.Conclusion Open MR-guided injection of oxygen-ozone, mounted with optical tracking system,is a safe and effective minimally invasive therapy for treating LDH.