Ozone discectomy vs interlaminar epidural steroid injection in prolapsed lumbar intervertebral disc: a randomized controlled study

Low back pain is a very frequent reason for medical consultations with lifetime prevalence as high as 84%. Ozone therapy has emerged as an alternative non-surgical intervention for intervertebral disc prolapse. A reduction in herniated disc volume is one of the therapeutic goal for intradiscal administration of ozone, as a reduction in disc size reduces nerve root compression and venous stasis and hence improves the microcirculation and supply of oxygen. A study was done at PMR Department, RIMS, Imphal to assess the effectiveness of intradiscal ozone and interlaminar epidural steroid injection in reducing pain and disability in prolapsed lumbar intervertebral disc. Eighty patients enrolled in the study were allocated to 2 groups (Group A and B). Group A (n=40) received intradiscal plus epidural ozone injection while Group B (n=40) received interlaminar epidural steroid injection. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used as outcome measures. Group A showed signi􀃶cant improvement in pain from baseline to 6 months as shown by reduction in VAS score from 7.23±0.95 to 1.62±0.72 and 7.28±1.01 to 2.08±0.64 in Group B (p=0.000). Reduction in ODI from 68.70±8.33 (baseline) to 17.03±7.76 (6 months) in Group A was signi􀃶cantly (p=0.000) more than that of Group B, 73.80±7.68 (baseline) to 25.68±5.89 (6 months). The study concluded that intradiscal ozone injection is more effective than interlaminar epidural steroid injection in reducing pain and disability in prolapsed lumbar intervertebral disc at 6 months.