Comparison of imaging findings of before and after intra diskal ozone therapy in herniated lumbar disks patients

Abstract

The purpose of this study was to investigate changes in the lumbar disc after ozone injection using MRI. Material & Methods: In this clinical trial study, 104 patients with LBP due to lumbar disc herniation referred to Imam Reza Hospital were divided into two groups: fluoroscopic-guided percutaneous ozone injection and medical therapy. MRI was taken from all patients before intervention and 6 months after, and the type of lumbar herniation, the grade of spinal and neuroforaminal stenosis, the grade of disc degeneration and nerve root compression were evaluated in both groups. Results: The mean age of patients in the ozone group (54 patients) was 50.11 ± 14.37 and 44.93 ± 13.94 years in the medical therapy group (50 patients) (P = 0.040). The most common location of lumbar herniation among the participants was central (47.4%) and the least common was extraforaminal (3.8%). In the ozone receiving group, there was no significant difference between the imaging findings of before and and after intervention. There was no significant difference between the two groups in the MRI findings before intervention. Evaluating finding of 6 months of intervention MRI, there was no difference between the two study groups in regard to the type of herniation, disk degeneration, nerve root compression, and neuroforaminal stenosis. In medical therapy group, patients with grade 2 of spinal stenosis increased after 6 months, while in the ozone group, there was no increase in grade 2 spinal stenosis (P = 0.004). Conclusion: Our study showed that percutaneous ozone injection may not change the patient's MRI findings, but compared to medical therapy, could prevent the progresuin of spinal stenosis in patients with lumbar disc herniation. Although, ozone injection was not significantly superior to medical therapy due to analysis of changes in MRI findings in our study, due to the difference in baseline mean age of the two groups, further studies should be conducted with similar characteristic for better conclusion.