Journal of Orthopedics

Observational Study

SUCCESSFUL USE OF OXYGEN-OZONE THERAPY UNDER CT GUIDE ASSOCIATED WITH ALPHA LIPOIC ACID + PALMITOYLETHANOLAMIDE AND MYRRH IN A 3-YEAR COHORT OF PATIENTS WITH FIRST-DEGREE SPONDYLOLISTHESIS SECONDARY TO SPONDYLOLYSIS

M. Bonetti1, M. Frigerio1 , G.M. Ottaviani2 , G. Pellicanò3, M. Muto4 ORCID, S. Miglio5, F. Maffezzoni5

1 Department of Neuroradiology, Clinical Institute, “Città di Brescia”, Brescia, Italy
2 Department of Emergency, Civil Hospitals of Brescia, Brescia, Italy
3 Department of Neuroradiology, Hospital Authority, Careggi University, Florence, Italy
4 Department of Neuroradiology Cardarelli Hospital of Naples, Naples, Italy
5 Oberdan Specialist Outpatient Clinic, Brescia, Italy

Correspondence to:

M. Bonetti, MD
Department of Neuroradiology,
Clinical Institute, “Città di Brescia”,
Via Bartolomeo Gualla 15,
25128, Brescia, Italy

Journal of Orthopedics 2024 September-December; 16(3): 126-134


Received: 25 July 2024 Accepted: 7 September 2024

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Abstract

In recent years, there has been an increase in reports on the use of oxygen-ozone therapy for the treatment of non-discogenic low back pain. The aim of our observational study was to compare the therapeutic efficacy of combined oxygen-ozone treatment with the oral administration of 800 mg/day of alpha-lipoic acid (ALA), 600 mg/day of palmitoylethanolamide (PEA), and 200 mg of myrrh in patients with first-degree spondylolisthesis secondary to spondylolysis, against the results obtained with oxygen-ozone treatment alone. From March 2021 to March 2024, we recruited 286 patients diagnosed with first-degree spondylolisthesis secondary to spondylolysis, confirmed through CT and/or MRI studies. All patients were experiencing low back pain and sciatica. Specifically, we treated 161 men and 125 women, aged between 36 and 74 years (mean age: 47.6). All participants in the study received Oxygen-Ozone Therapy, monitored by CT, along with an oral regimen of alpha-lipoic acid (ALA), palmitoylethanolamide (PEA), and myrrh, taking two capsules per day for 30 days. The 286 treated patients were evaluated at the time of recruitment using the Visual Analog Scale (VAS). Clinical outcomes were assessed in the long term at six months, utilizing both the VAS and the modified MacNab method. The results obtained were then compared with those reported in the literature for patients receiving only oxygen-ozone treatment under CT guidance. The VAS questionnaire showed satisfactory clinical results after treatment (M = 8.47, SD = 0.76 pre-treatment; M = 2.48, SD = 1.32 after treatment). These data were also confirmed using the modified Mac Nab method, with which we obtained an excellent result in 185 (64.70%), while in 40 it was satisfactory (13.95%). Out of 286 patients, 38 patients (13.3%) did not report any benefit as reported by the VAS test. These results were then compared with those reported in the literature with oxygen-ozone treatment alone. In light of the results obtained from our observational study involving 286 patients, we compared our findings, combining Oxygen-Ozone Therapy under CT guidance with oral administration of ALA, PEA, and myrrh, to data reported in the literature regarding oxygen-ozone therapy alone. We conclude that this combination therapy results in further improvement over the already excellent outcomes achieved with oxygen-ozone treatment alone. Therefore, we consider this therapeutic combination of ALA, PEA, and myrrh to be a valid alternative to standalone oxygen-ozone therapy.

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