J Neurol Surg A Cent Eur Neurosurg 2019; 80(06): 503-506
DOI: 10.1055/s-0039-1685197
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Suspected Pulmonary Embolism after Oxygen-Ozone Therapy for Low Back Pain

Domenico Chirchiglia
1   Department of Neurosurgery, University of Catanzaro, Catanzaro, Italy
,
Pasquale Chirchiglia
1   Department of Neurosurgery, University of Catanzaro, Catanzaro, Italy
,
Carmelino Stroscio
1   Department of Neurosurgery, University of Catanzaro, Catanzaro, Italy
,
Giorgio Volpentesta
1   Department of Neurosurgery, University of Catanzaro, Catanzaro, Italy
,
Angelo Lavano
1   Department of Neurosurgery, University of Catanzaro, Catanzaro, Italy
› Author Affiliations
Further Information

Publication History

13 July 2018

17 October 2018

Publication Date:
20 August 2019 (online)

Abstract

Oxygen-ozone therapy is used to treat degenerative pathology of the spine when surgery is not needed (e.g., removal of a herniated disk). Some authors have described it as a safe and effective procedure in ∼ 70 to 90% of patients. The aim of the therapy is to dehydrate the intervertebral disk and alter its contents. However, this treatment has been associated with some rare but very serious side effects. Both cardiac damage and a case of fulminant septicemia were reported. We describe a case of suspected pulmonary embolism, followed by sudden death, in an elderly woman treated with oxygen-ozone therapy for lumbar pain caused by disk protrusion. We believe a massive pulmonary embolism occurred, probably caused by an intradiskal injection that accidentally punctured a venous vessel and created emboli.

 
  • References

  • 1 Magalhaes FN, Dotta L, Sasse A, Teixera MJ, Fonoff ET. Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials. Pain Physician 2012; 15 (02) E115-E129
  • 2 Tang WJ, Jiang L, Wang Y, Kuang ZM. Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease: a case report. Medicine (Baltimore) 2017; 96 (50) e9265
  • 3 Beyaz SG, Altaş C, Sayhan H. Cardiopulmonary arrest and pneumoencephaly developing after epidural oxygen-ozone mixture therapy. Anesth Essays Res 2018; 12 (01) 285-287
  • 4 Gazzeri R, Galarza M, Neroni M, Esposito S, Alfieri A. Fulminating septicemia secondary to oxygen-ozone therapy for lumbar disc herniation: case report. Spine 2007; 32 (03) E121-E123
  • 5 Iliakis E, Valadakis V. Rationalization of the activity of medical ozone on intervertebral disc: a histological and biochemical study. Rev Neuroradiol 2001; 14 (01) 23-30
  • 6 Paoloni M, Di Sante L, Cacchio A. , et al. Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection. Spine 2009; 34 (13) 1337-1344
  • 7 Leonardi M, Barbara C, Agati R. , et al. Percutaneous treatment of herniated lumbar disc by intradiscal injection of ozone mixture. Rev Neuroradiol 2001; 14 (01) 51-53
  • 8 Steppan J, Meaders T, Muto M, Murphy KJ. A metaanalysis of the effectiveness and safety of ozone treatments for herniated lumbar discs. J Vasc Interv Radiol 2010; 21 (04) 534-548
  • 9 Muto M, Giurazza F, Silva RP, Guarnieri G. Rational approach, technique and selection criteria treating lumbar disk herniations by oxygen-ozone therapy. Interv Neuroradiol 2016; 22 (06) 736-740
  • 10 Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res 2006; 37 (04) 425-435
  • 11 Alexandre A, Corò L, Azuelos A. , et al. Intradiscal injection of oxygen-ozone gas mixture for the treatment of cervical disc herniations. Acta Neurochir Suppl (Wien) 2005; 92: 79-82