Percutaneous Computed Tomography-Guided Oxygen-Ozone (O2O3) Injection Therapy in Patients with Lower Back Pain—An Interventional Two-Year Follow-Up Study of 321 Patients

Author:

Davidovic Kristina1,Cotofana Sebastian234,Heisinger Stephan5,Savic Slavica6,Alfertshofer Michael7ORCID,Antonić Tatjana1ORCID,Jovanović Sanja8,Ercegovac Marko9,Muto Mario10,Jeremić Danilo11ORCID,Janićijević Aleksandar12ORCID,Rasulić Lukas12,Janošević Vesna12,Šarić Lidija12,Chua Deborah13,Masulovic Dragan1,Maksimović Ružica1

Affiliation:

1. Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia

2. Department of Dermatology, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands

3. Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London E1 4NS, UK

4. Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou 510317, China

5. Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria

6. Medical Faculty, University of Belgrade, 11120 Belgrade, Serbia

7. Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, 80336 Munich, Germany

8. Acibadem Bel Medic, 11000 Belgrade, Serbia

9. Clinic of Neurology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia

10. Neuroradiology Department, Ospedale Cardarelli Napoli, 80131 Napoli, Italy

11. Institute for Orthopedic Surgery “Banjica”, 11000 Belgrade, Serbia

12. Clinic of Neurosurgery, University Clinical Centre of Serbia, 11000 Belgrade, Serbia

13. MH Plastic Surgery, Singapore 238859, Singapore

Abstract

Objectives: To assess the effect of oxygen-ozone therapy guided by percutaneous Computed Tomography (CT) compared to corticosteroids in individuals experiencing lower back pain (LBP) not attributed to underlying bone-related issues. Methods: A total of 321 patients (192 males and 129 females, mean age: 51.5 ± 15.1 years) with LBP were assigned to three treatment groups: group A) oxygen-ozone only, group B) corticosteroids only, group C) oxygen-ozone and corticosteroids. Treatment was administered via CT-guided injections to the intervertebral disc (i.e., intradiscal location). Clinical improvement of pain and functionality was assessed via self-reported pain scales and magnetic resonance (MR) and CT imaging. Results: At all follow-up times, the mean score of the numeric rating scale and the total global pain scale (GPS) of study groups receiving oxygen-ozone (groups A and C) were statistically significantly lower than the study group receiving corticosteroids only (group B), with p < 0.001. There was a statistically significant difference between groups A and C at 30 days for the numeric rating scale. Conclusions: The percutaneous application of oxygen-ozone in patients with LBP due to degeneration of the lumbosacral spine showed long-lasting significant pain reduction of up to two years post-treatment when compared to corticosteroids alone. Combination therapy of oxygen-ozone and corticosteroids can be useful as corticosteroids showed statistically significant improvement in LBP earlier than the oxygen-ozone-only treatment.

Publisher

MDPI AG

Subject

Clinical Biochemistry

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