Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research.

Abstract

Introduction: Epidural fibrosis (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the postoperative period. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.

Material and methods: This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague-Dawley rats were divided into four groups, as follows: Control Group (CG) (n = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (n = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (n = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (n = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.

Results: No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (p = 0.728; p = 0.813; p = 0.152; and p = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (p = 0.007); however, no statistically significant differences were observed among other groups (p > 0.05).

Conclusions: In our study, we could not record the positive effect of ozone therapy in terms of histopathology and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.