title: Percutaneous treatment of non-contained lumbar disc herniation by injection of oxygen-ozone combined with collagenase.
abstract: OBJECTIVE
  To evaluate the therapeutic results of oxygen-ozone combined collagenase injection for the treatment of lumbar disc herniation compared to the surgery. And to explore the role of this minimally invasive treatment as an alternative to disc surgery.
  
  
  METHODS
  Two groups of patients (n=108) were treated with different ways respectively. Minimally invasive group of patients was treated with the injection of oxygen-ozone combined with collagenase into the lumbar disc or the epidural space; the other group was treated with traditional surgery. After the treatment, the patients were followed-up and the therapeutic effect was assessed at 2 weeks, 3 and 12 months by the modified Macnab criteria.
  
  
  RESULTS
  The success rate was 86.11% and 88.89% in minimally invasive group at 3 and 12 months respectively, while 92.59% and 95.37% in surgical group. There was no statistically significant difference between two groups at 3 and 12 months (P=0.123, P=0.08). However, the surgical group produced a statistically significant greater improvement for back pain and disability in the first few weeks (P=0.0001). The success rate was 51.86% and 85.18% at 2 weeks in minimally invasive group and surgical group respectively. No serious complication occurred in this group.
  
  
  CONCLUSIONS
  The combination of the oxygen-ozone with collagenase shows significant reductions in pain and improvements in function at 3 and 12 months, it can be considered as an option for the treatment of non-contained lumbar disc herniation instead of surgery.
authors.affiliation: Therapy Center of Pain, Division of Interventional Radiology, Tang Du Hospital, The Fourth Military Medical University, Xian 710038, China. zhiqunwu@yahoo.com
authors.forename: Zhiqun
authors.initials: Z
authors.lastname: Wu
authors.forename: Long Xiao
authors.initials: LX
authors.lastname: Wei
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Wang
authors.forename: Daihui
authors.initials: D
authors.lastname: Ni
authors.forename: Peng
authors.initials: P
authors.lastname: Yang
authors.forename: Yuhai
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D017364:Collagenases / Q000008:administration & dosage*; D017586:Diskectomy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000379:methods; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000187:drug effects* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D010126:Ozone / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010126:Ozone; D017364:Collagenases; D010100:Oxygen