Intraforaminal ozone therapy and particular side effects: preliminary results and early warning
Vanni D, Galzio R, Kazakova A, Pantalone A, et al. Acta Neurochirurgica, 2016.
- Study type
- Case series
- People studied
- 186 people
- Population
- 186 patients (97 men, 89 women, mean age 59.8) having microsurgery for lumbar disc hernia or segmental stenosis; 23 had prior intraforaminal ozone, 28 intraforaminal steroids
- Published
- 2016, Acta Neurochirurgica
- Identifiers
- PMID 26293228, DOI 10.1007/s00701-015-2545-y
What the authors reported
During lumbar microsurgery in 186 patients, surgeons found hard adhesions between soft tissues and bone, with the nerve root contracted and firmly adherent to the dural sac or disc fragments, only in the group previously given intraforaminal ozone (23 patients, treated elsewhere 12 to 24 months earlier). Patients with no injections or with intraforaminal steroids showed no such abnormalities.
What limits this result
Surgical series reported as preliminary results, read from the abstract only. The abstract does not give the size of the no-injection group, how many of the 23 ozone-treated patients had adhesions, whether the surgeons knew each patient's treatment history, or the ozone concentration and volume used.
Harms reported after ozone therapy, and studies of how ozone exposure affects health. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Series of patients who underwent lumbar microsurgery since 2013, compared by prior intraforaminal treatment
Since 2013, 186 patients (97 males and 89 females, mean age 59.8 years) have undergone microsurgery for lumbar disc hernia or lumbar segmental stenosis.
- Setting
- Orthopaedic and Traumatology Department and Vertebral Surgery Department, G. d'Annunzio University, ASL 2 Lanciano Vasto, Chieti, Italy (first-listed affiliation)
- Read from
- Read from the abstract only; where this page says nothing about an item, the abstract does not report it. Read on October 2, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| All patients having microsurgery since 2013 | 186 | Microsurgery for lumbar disc hernia or lumbar segmental stenosis |
| Previously treated with intraforaminal ozone | 23 | Ozone therapy by the intraforaminal approach in other hospitals, 12 to 24 months before evaluation |
| Previously treated with intraforaminal steroids | 28 | Intraforaminal steroid injections in other hospitals, 12 to 24 months before evaluation |
Source: Abstract on PubMed
Procedure as reported
- Sessions
- 16 applications in an 8-week period ('standard therapy'), stated for 'these patients' without separating the ozone and steroid groups
In the paper's own units, not converted.
Source: Abstract on PubMed
What it measured
- Findings during surgery
- Many hard adhesions between the soft tissues and bony structures, unexpectedly discovered
- Nerve root
- Root contracted, with firm adhesions to the dural sac and/or fragmented disc that were difficult to resolve
- Patients showing these patterns
- Only patients who received ozone injections by the intraforaminal approach
- Patients with no injections or with intraforaminal steroid injections
- No pathological abnormalities found
We did not find any pathological abnormalities in the patients who did not receive any injections or who received intraforaminal steroid injections.
- Mechanical needle damage
- Excluded by the authors as the cause of the tissue damage
Thus, we could exclude that the tissue damage was due to the mechanical action of the needle.
- Authors' conclusion
- Ozone therapy procedures can be associated with several major complications; a revision of the guidelines and protocols is indispensable
Source: Abstract on PubMed
Safety as reported
Hard adhesions, with the nerve root contracted and adherent to the dural sac or disc, found at surgery only in patients previously given intraforaminal ozoneThese specific pathological patterns were observed only in the patients who received ozone injections by the intraforaminal approach.
Source: Abstract on PubMed
Where we cite this study
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