Background: Intradiscal ozone therapy, a minimally invasive technique, is used in patients that do
not respond to standard conservative therapies for low back pain due to degenerative disc-induced
lumbar disc herniation (LDH). Many studies on clinical efficacy lack a standardized injection method
and are limited by inadequate study design.
Objective: This study aimed to determine the efficacy of periforaminal steroid injection together
with intradiscal ozone therapy.
Study Design: A prospective, double-blinded, randomized controlled trial.
Setting: A tertiary care center.
Methods: This study was conducted in 65 patients with low back and leg pain caused by LDH.
Group 1 received intradiscal ozone therapy (n = 35) and Group 2 received intradiscal ozone therapy
with periforaminal steroid injection (n = 30). Patients were evaluated for pain using the visual
analogue scale (VAS), for disability using Oswestry Disability Index (ODI), and for quality of life
using the short form 36 health survey administered pre-injection and at one and 6 months postinjection. All procedures were performed under sterile conditions using C-arm fluoroscopy.
Results: Significant improvements were observed in pain, disability, and quality of life in both
groups post-treatment compared to pre-injection. Mean pre-injection VAS was not significantly
different between the groups (VAS: 7.8 ± 1.1 for Group 1, 7.8 ± 1.2 for Group 2). VAS values
at 6 months for Group 1 and Group 2 were as follows: 3.6 ± 2.4, 4.1 ± 1.6, respectively) (P <
0.001). Mean pre-injection ODI was not significantly different between the groups (ODI: 20.9
± 9.6 for Group 1, 25.2 ± 10.3 for Group 2). ODI values at 6 months for Group 1 and Group
2 were as follows: 12.8 ± 9.2, 14.3 ± 7.2, respectively) (P < 0.001). However, there were no
significant differences between the groups. Similarly, there was no significant difference between
the 2 groups on any of these parameters.
Limitations: A limited number of patients and limited follow-up time.
Conclusion: This study showed that intradiscal ozone injection alone was sufficient to treat
low back and leg pain caused by LDH and that periforaminal steroid injection does not provide
additional benefit, which is contrary to the literature.
Key words: Low back pain, intradiscal ozone, steroid, lumbar disc herniation, lumbar disc
degeneration
Evaluation of the Clinical Curative Effect of an O2-O3 mixture to Treat Lumbar Disc Herniation with Different Treatment Sessions