Massimo PiracciMedcare Orthopedic and Spinal Hospital Dubai, Unites Emirates Arab
Title: Ozone therapy in disc herniation as advance treatment
Ozone (O3) is an unstable allotropic form of oxygen that imparts an oxidizing activity with various biological components. It can generate its immune-modulating, anti-inflammatory, antibacterial, virucidal, fungicidal, analgesic, and other properties depending on the therapeutic dose chosen. Ozone therapy has various therapeutic uses including topical applications for wound healing, treatment of periodontitis, cancer, AIDS, severe acute respiratory syndrome, neurodegenerative diseases and diabetic foot. Ozone therapy is indicated in lumbar herniated disc. Lumbar herniated disc causes symptoms of sciatica and possible foot pain, numbness or weakness. Ozone is administered in the form of an oxygen-ozone gas mixture, at nontoxic concentrations varying from 1 to 40 ?g of ozone per milliliter of oxygen. The optimal concentration of ozone per milliliter of oxygen for intradiscal administration is 27?g. Several clinical studies on the efficacy of the use of O2-O3 in treatment of lumbar disc herniations have been reported in the literature. Patients with neck pain and or radiculopathy corresponding to disc herniation without cervical cord compression are most suitable for ozone therapy. Ozone therapy is a minimally invasive treatment that provides antiinflammatory effects and pain relief by oxidizing proteoglycan in the nucleus pulposus leading to shrinkage of the disc which compresses the nerve roots. A powerful stimulus to the activation of antioxidant defense is the result of O3 injected in the peridural space of the conjugation foramen and disc. The overall procedural complications rate is estimated around 0.1%. Steppan J et al (2010) determined that the complication rate was much lower (<0.1%) and the recovery time was significantly shorter with ozone therapy. Magalhaes FN et al indicated the level of evidence in the systematic meta- analysis of therapeutic results of percutaneous injection of ozone for low back pain secondary to disc herniation for long-term pain relief was found to be II-3 for ozone therapy applied intradiscally and II-1 for ozone therapy applied paravertebrally. The grading of recommendation was 1C for intradiscal ozone therapy and 1B for paravertebral ozone therapy.
Massimo Piracci completed his MBBS from Roma Tor Vergata, Italy in 1992 and subsequently received his MD in Orthopedic and Traumatology from the same University in 1999. He was trained in Orthopedic Surgery in Roma Saint Eugenio Hospital and in Latina Santa Maria Goretti Hospital. From 2003 was HOD in Orthopedic and Traumatology Department in Roma Clinic Annunziatella where he did more than 10.000 surgery. He was also Football Referee for FIGC for 15 years and also external orthopedic consultant for different football team. From 2014 in UAE. He uses the most advanced technologies and biological implant (PRP, Stamina cells, Ozone Therapy) and mini invasive surgery of hip head. He treats the most of orthopedic pathology for children and adults, the most of minor and major trauma, and sport injury with advanced mini invasive technique. For low back pain he uses the treatment with Ozone therapy that resolve the pain giving back a normal life to the patient. He was the HOD of Orthopedic department in Czech Rehabilitation Hospital in Al Ain and HOD of Regenerative and Sport Medicine in Adam Vital Hospital in Dubai. Consultant Orthopedic Surgeon in Saudi German Hospital in Dubai. Consultant Orthopedic surgeon in Emirates Hospital Group, he is Consultant Orthopedic surgeon, Regenerative Medicine and Sport Medicine in Medcare Orthopedic Spinal Hospital Dubai. Speaker well known in many Nation and International Conference and publishing.