title: Ozone-augmented percutaneous discectomy: a novel treatment option for refractory discogenic sciatica.
abstract: OBJECTIVE
  To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD).
  
  
  METHODS
  One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups.
  
  
  RESULTS
  OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group.
  
  
  CONCLUSIONS
  OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort.
authors.affiliation: Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. Electronic address: crockettmt@gmail.com.
authors.forename: M T
authors.initials: MT
authors.lastname: Crockett
authors.affiliation: Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Moynagh
authors.affiliation: Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: Long
authors.affiliation: Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Kilcoyne
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons Ireland, 123 St Stephens Green, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Dicker
authors.affiliation: Department of Orthopaedics, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: Synnott
authors.affiliation: Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
authors.forename: S J
authors.initials: SJ
authors.lastname: Eustace
mesh_terms: D015331:Cohort Studies; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010126:Ozone / Q000008:administration & dosage*; D012585:Sciatica / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D010126:Ozone