Comparative evaluation of oxygen-ozone therapy and combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation for the treatment of lumbar disc herniation

Abstract

Aim: To compare the efficacy of oxygen-ozone therapy and the combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of contained lumbar disc herniation.

Methods: Ninety-one adult patients with low back pain secondary to contained lumbar disc herniation were randomly assigned into two groups. Ozone group received intradiscal oxygen-ozone therapy (4 to 7 mL of oxygen ozone mixture); ozone-PIRFT group received a combination of oxygen-ozone therapy with PIRFT (radiofrequency lesioning at 80°C for 360 s).

Outcome measures: Primary outcome measures included a visual analog scale (VAS) for pain and the Oswestry disability index (ODI). Secondary outcome measures included pain relief, reduction of analgesic consumption, and patient's satisfaction. Clinical assessment of these outcome measures was performed at 2 weeks, 1 month, 3 months, 6 months, and 1 year after the procedure.

Results: VAS scores and ODI were significantly decreased by both ozone and ozone-PIRFT when compared with the baseline values at all points of follow-up; however, ozone-PIRFT produced a significant reduction in the VAS scores and ODI when compared to ozone at 2 weeks, 1 month, 3 months, 6 months, and 1 year follow-up. Ozone-PIRFT also resulted in a significant change in all secondary measures at all points of follow-up, as compared with the ozone group.

Conclusion: Ozone-PIRFT is more efficacious than ozone alone in reducing pain scores, analgesic consumption, improving functional outcome, and satisfaction of patients with contained lumbar disc herniation.