Indications and efficacy of O2-O3 intradiscal versus steroid intraforaminal injection in different types of disco vertebral pathologies: a prospective randomized double-blind trial with 517 patients

Radiol Med. 2016 Jun;121(6):463-71. doi: 10.1007/s11547-015-0598-x. Epub 2015 Dec 16.

Abstract

Objective: The aim of this study was to prospectively evaluate the clinical efficacy of perigangliar steroid and local anesthetic with intradiscal O2-O3 injection versus steroid and local anesthetic intraforaminal injection in different types of herniation and grade of disc degeneration.

Materials and methods: A total of 517 patients were randomly assigned to two groups. Control Group (159 men, 101 women; age range 25-89 years) underwent steroid and local anesthetic intraforaminal injection. Study Group (163 men, 94 women; age range 22-92 years) underwent the same treatment with addiction of O2-O3 intradiscal injection. Procedures were performed under computed tomographic guidance. Visual Analog Scale Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Results were compared with Kruskal-Wallis and t test.

Results: After 6 months, O2-O3 discolysis was successful in 106 (41.24 %) Study Group patients with extrusions compared with 9 Control Group patients (3.5 %) (P < 0.001). In 89 (34.6 %) Study Group patients with protrusions, success rate was statistically significant compared with 5 Control Group patients (1.9 %). Significant difference was detected in the presence of Grade I, II, III of Degenerated Disc in 185 of Study Group patients (68.4 %) compared with 4 Control Group patients (1.5 %).

Conclusions: The addition of O2-O3 discolysis is more effective at 6 months than perigangliar steroid and local anesthetic injection, especially in cases of herniated or protruded discs and with a Grade of Disc Degeneration from mild to moderate range.

Keywords: Chemiodiscolysis; Herniation disc; O2–O3 discolysis; Percutaneous treatment; Sciatica.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Injections, Intralesional
  • Intervertebral Disc Chemolysis / methods*
  • Intervertebral Disc Displacement / therapy*
  • Male
  • Middle Aged
  • Oxygen / therapeutic use*
  • Ozone / therapeutic use*
  • Prospective Studies
  • Radiography, Interventional
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Ozone
  • Oxygen