Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study.
OBJECTIVE
Reports about steroids and oxygen-ozone therapy to treat lower back pain have been increasing. The purpose of our study was to compare the clinical outcomes in patients treated with infiltrations of O(2)-O(3) gas or steroids at short-, medium-, and long-term follow-up.


METHODS
A total of 306 patients (166 with primarily disk disease, 140 with nondisk vertebral disease) with acute or chronic low back and sciatic nerve pain received a CT-guided intraforaminal infiltration of an O(2)-O(3) gas mixture or an periradicular infiltration of steroids. Neurologists unaware of the type of treatment assessed the patients.


RESULTS
At 1-week follow-up, most patients had a complete remission of pain, regardless of the treatment. At 6-month follow-up, differences in favor of O(2)-O(3) treatment were significant in patients with disk disease (P = .0021) but not in those without disk disease (P = .0992). Clinical outcomes were poor in 13 (15.1%) of 86 patients receiving O(2)-O(3) infiltration and in 18 (22.5%) of 80 patients receiving steroid injection (P = .2226). Among patients without disk disease, six (8.6%) of 70 patients receiving O(2)-O(3) infiltration but 21.4% of the patients receiving steroid injections had poor outcomes (P = .0332).


CONCLUSIONS
Oxygen-ozone treatment was highly effective in relieving acute and chronic lower back pain and sciatica. The gas mixture can be administered as a first treatment to replace epidural steroids.
Bonetti
Matteo
M
Department of Neuroradiology and Division of Neurology, Istituto Clinico Città di Brescia, Italy.
Fontana
Alessandro
A
Cotticelli
Biagio
B
Volta
Giorgio Dalla
GD
Guindani
Massimiliano
M
Leonardi
Marco
M
D000328:Adult; D000368:Aged; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D010126:Ozone / Q000008:administration & dosage*; D012585:Sciatica / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*
D004338:Drug Combinations; D013256:Steroids; D010126:Ozone; D010100:Oxygen