Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only.
OBJECTIVE
To prospectively compare the clinical effectiveness of intraforaminal and intradiscal injections of a mixture of a steroid, a local anesthetic, and oxygen-ozone (O(2)-O(3)) (chemodiscolysis) versus intraforaminal and intradiscal injections of a steroid and an anesthetic in the management of radicular pain related to acute lumbar disk herniation.


METHODS
Medical Ethical Committee approval and informed consent were obtained. One hundred fifty-nine patients (86 men, 73 women; age range, 18-71 years) were included and were randomly assigned to two groups. Seventy-seven patients (group A) underwent intradiscal and intraforaminal injections of a steroid and an anesthetic, and 82 patients (group B) underwent the same treatment with the addition of an O(2)-O(3) mixture. Procedures were performed with computed tomographic guidance. An Oswestry Low Back Pain Disability Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Patients and clinicians were blinded as to which treatment was performed. Results were compared with the chi(2) test.


RESULTS
After 6 months, treatment was successful in 36 (47%) patients in group A and in 61 (74%) patients in group B. The difference was significant (P < .01).


CONCLUSIONS
Intraforaminal and intradiscal injections of a steroid, an anesthetic, and O(2)-O(3) are more effective at 6 months than injections of only a steroid and an anesthetic in the same sites.
Gallucci
Massimo
M
Department of Radiology, University of L'Aquila, S Salvatore Hospital, Coppito, 67100 L'Aquila, Italy.
Limbucci
Nicola
N
Zugaro
Luigi
L
Barile
Antonio
A
Stavroulis
Emmanouil
E
Ricci
Alessandro
A
Galzio
Renato
R
Masciocchi
Carlo
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000777:Anesthetics / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D010126:Ozone / Q000008:administration & dosage*; D012585:Sciatica / Q000188:drug therapy* / Q000209:etiology; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
D000777:Anesthetics; D000893:Anti-Inflammatory Agents; D004338:Drug Combinations; D013256:Steroids; D010126:Ozone; D010100:Oxygen