Medical ozone is an allotrope of oxygen composed of three oxygen atoms. It is the most active form of oxygen [11]. Ozone can decompose into oxygen and single oxygen atoms in about 20 minutes under normal temperature and pressure. A single oxygen has a strong activity, and has a strong oxidizing effect on bacteria, viruses and other microorganisms, as well as proteoglycans, lipids, and inflammatory mediators. Oxidized proteoglycan: It oxidizes nucleus pulposus proteoglycan, destroys nucleus pulposus cells, makes the osmotic pressure of the nucleus pulposus matrix unable to be maintained, and loses water, thereby reducing the pressure in the intervertebral disc, retracting the disc herniation, and eliminating the compression on the nerve root. Anti-inflammatory: Ozone can antagonize the immune factors and inflammatory mediators released in the inflammatory response, reduce nerve root edema and adhesion, and achieve the purpose of anti-inflammatory. Analgesia: The strong oxidation of ozone can quickly inactivate inflammatory mediators and eliminate pain. Loosen: Loosen the adhesion of nerve roots and intervertebral discs and surrounding tissues.
The anti-inflammatory analgesic solution is composed of 0.25% lidocaine needle, 4 mg triamcinolone acetonide injection, 0.9% sodium chloride solution. Lidocaine is a local anesthetic of the amide type. It has obvious excitatory and inhibitory bidirectional effects on the central nervous system, and there can be no pioneer excitement. When the blood concentration is low, analgesia and expansion of blood vessels can improve local blood circulation. Triamcinolone acetonide injection is an adrenal cortex hormone drug, which has anti-inflammatory and anti-allergic effects and suppresses immune response. This study found that injecting anti-inflammatory analgesic solution into the internal orifice of the nerve root can reduce nerve root edema and achieve the purpose of anti-inflammatory and analgesic.
Treatment of lumbar disc herniation should be more humane. In the treatment of lumbar disc herniation, more doctors prefer open surgery [12–13]. Although our department does not deny that open surgery is intuitive and thorough in the treatment of lumbar disc herniation, we do not approve of it as a routine treatment, because this method is severely destructive in the normal biomechanics of the human body [14–16], we have compressed the original indications for open surgery and recommend more patients to use minimally invasive treatment to maintain biomechanical stability. Practice has proved that minimally invasive treatment is effective in treating lumbar disc herniation and does not affect any subsequent treatment.
Indications and contraindications for minimally invasive treatment of lumbar intervertebral disc herniation [17–18]: Absolute indications: a. Slow onset of the disease for no more than 1 year; b. Incomplete nerve injury; c. Patients accept minimally invasive treatment. Relative indications: a. Symptoms appear in slow-onset cases between 1 and 3 years with intermittent symptoms; b. It is accompanied by cardiovascular and cerebrovascular diseases at the same time; c. Patients have doubts about minimally invasive treatment. Contraindications: a. The disease persists for more than 3 years; b. Complete nerve damage; c. The prominent nucleus pulposus is completely free; d. Patient have severe cardiovascular and cerebrovascular diseases and mental diseases.
The key points of minimally invasive treatment of lumbar disc herniation: first of all, the diagnosis must be accurate. This requires clinicians engaged in minimally invasive treatment to have a solid theoretical foundation and sufficient clinical experience, especially the differential diagnosis should be accurate [19–20]. Secondly, the positioning must be accurate. This requires doctors not only not to be sloppy in the diagnosis of nerve positioning, but also to be particularly accurate in positioning during the treatment process, otherwise the treatment effect will plummet [21].
In addition, it is very important to provide psychological counseling for patients with lumbar disc herniation. Patients with lumbar disc herniation have a long onset period. Most patients will experience depression and even commit suicide. In the treatment of lumbar disc herniation, patients must be encouraged and helped to build up the self-confidence to overcome the disease.
With the advancement of science and technology and the continuous improvement of material and cultural living standards, our work and learning environment and living habits have changed, and the incidence of a series of spinal diseases such as cervical spondylosis and lumbar disc herniation has increased year by year. And the trend is that there are more young patients. Lumbar disc herniation is mainly manifested by pain in the lower back and legs, or not accompanied by pain and numbness in the lower limbs. Most patients have limited mobility and motor dysfunction, which brings great pain and inconvenience to the work and life of patients. Rapid pain relief and improvement of motor dysfunction have become the most urgent requirements of patients. We are constantly exploring clinically, consulting medical-related literature, going out to learn, summing up experience, and actively exploring new treatment methods. To sum up, through clinical application, we found that "clinical study on the treatment of lumbar disc herniation with radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with hook operation of traditional Chinese medicine" has significant clinical effect compared with single lumbar disc radiofrequency treatment for lumbar disc herniation, which can quickly relieve pain symptoms, improve motor function, and directly treat the target of the lesion, that is the protrusion. It has been recognized and praised by the majority of patients, and has good social and economic benefits. In qualified hospitals, efforts should be made to relieve the pain of patients with lumbar disc herniation and resume normal life as soon as possible.
This research still has the following shortcomings. First of all, although this study is a randomized controlled experiment, it is not blinded. Secondly, this study is a single-center clinical study, and a multi-center clinical study is still needed for further discussion. Finally, the sample size included in this study is relatively small, and it is still necessary to increase the sample size for further research.