Epidural Steroid Injection vs Paravertebral O2O3 Infiltration for Symptomatic Herniated Disc Refractory to Conventional Treatment A Prospective Randomized Study
Summary - The medical management of patients with symptomatic herniated disc of the lumbar spine to treat low back pain, sciatica and cruralgia includes epidural injection of steroids and intramuscular paravertebral infiltration of an O2O3 mixture. Our study compared the short (three weeks) and long-term (six months) efficacy of the two treatments after failure to response to conventional medical management (steroids and muscle relaxants). 351 patients were enrolled: 171 (Group A) were treated by epidural steroid injection, while 180 (Group B) underwent paravertebral administration of an O2O3 mixture. In the short-term 59% of patients treated by epidural injection and 88.2% (p<0.05) of patients treated with O2O3 had a total or near total remission of pain. Long-term outcome remained excellent or good in 47.3% of patients treated by epidural injection and 77.1% (p<0.05) of patients treated with O2O3. Given the relative simplicity of treatment administration, limited contraindications and the lack of side-effects, ozone therapy is the first choice treatment in patients refractory to conventional medical management.
A. Zambello, B. Fara, G. Tabaracci, M. Bianchi