ESRA Academy. Sayhan H. Sep 8, 2016; 138515; 0379 Topic: Chronic Pain Management
Dr. Havva Sayhan
Dr. Havva Sayhan

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Background and Aims:

The injection of ozone gas inside the intervertebral disc has been used as an alternative to epidural steroids and surgical discectomy  and is done as an outpatient under local anaesthesia. This minimally invasive technique may reduce the risk of complications of open surgery, however the anatomy of adjacent structures  may cause some complications.

We aim to report our experience with a patient affected by hoarseness due to herniated cervical disk treated by intradiscal ozone injection.






The patient affected by cervical disc herniation at C5C6 ve C6C7 levels was treated with intradiscal injection of ozone. The patient was placed in supine position and the needle entry point was confirmed under ultrasound guidence by anterolateral approach. One of 22 G spinal needle was introduced into the disc at C5C6 level and the other at C6C7 level under fluoroscopy. The needle-tip position was confirmed and 3 ml of ozone at 20 μg/ml concentration was injected into each indicated level.


Following intradiscal ozone injection the patient had reduced pain but complained with hoarseness at 1 week follow up. A physical examination had carried out in order to establish a precise diagnosis  and vocal cord edema was determined. During repeated examination of the patient after 2 weeks postprocedure follow up without any treatment it was found that vocal cords naturally recovered.


Despite vocal cord injury following cervical spine procedures may occure it naturally recovers within a short time. We believe that cervical intradiscal ozone application should not be avoided because of risk of complications.

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