title: Indications and efficacy of O2-O3 intradiscal versus steroid intraforaminal injection in different types of disco vertebral pathologies: a prospective randomized double-blind trial with 517 patients.
abstract: OBJECTIVE
  The aim of this study was to prospectively evaluate the clinical efficacy of perigangliar steroid and local anesthetic with intradiscal O2-O3 injection versus steroid and local anesthetic intraforaminal injection in different types of herniation and grade of disc degeneration.
  
  
  METHODS
  A total of 517 patients were randomly assigned to two groups. Control Group (159 men, 101 women; age range 25-89 years) underwent steroid and local anesthetic intraforaminal injection. Study Group (163 men, 94 women; age range 22-92 years) underwent the same treatment with addiction of O2-O3 intradiscal injection. Procedures were performed under computed tomographic guidance. Visual Analog Scale Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Results were compared with Kruskal-Wallis and t test.
  
  
  RESULTS
  After 6 months, O2-O3 discolysis was successful in 106 (41.24 %) Study Group patients with extrusions compared with 9 Control Group patients (3.5 %) (P < 0.001). In 89 (34.6 %) Study Group patients with protrusions, success rate was statistically significant compared with 5 Control Group patients (1.9 %). Significant difference was detected in the presence of Grade I, II, III of Degenerated Disc in 185 of Study Group patients (68.4 %) compared with 4 Control Group patients (1.5 %).
  
  
  CONCLUSIONS
  The addition of O2-O3 discolysis is more effective at 6 months than perigangliar steroid and local anesthetic injection, especially in cases of herniated or protruded discs and with a Grade of Disc Degeneration from mild to moderate range.
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy. marco-perri@tiscali.it.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy. marco-perri@tiscali.it.
authors.forename: Marco
authors.identifier: http://orcid.org/0000-0001-6113-262X
authors.initials: M
authors.lastname: Perri
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marsecano
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Varrassi
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Aldo Victor
authors.initials: AV
authors.lastname: Giordano
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Neuroradiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Splendiani
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: di Cesare
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Radiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Masciocchi
authors.affiliation: S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy.|Division of Neuroradiology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gallucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use*; D010126:Ozone / Q000627:therapeutic use*; D011446:Prospective Studies; D015641:Radiography, Interventional; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D010126:Ozone; D010100:Oxygen
keywords: Chemiodiscolysis; Herniation disc; O2–O3 discolysis; Percutaneous treatment; Sciatica