AUTHOR=Yang Xiao-hui , Liu Xiao-hui , Ma Yun-gai , Fan Jia-xing , Ma Xiao-long , Zhuang Guan-ying , Yang Zhan-min 

TITLE=The clinical efficacy of ozone combined with steroid in the treatment of discogenic low back pain: a randomized, double-blinded clinical study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1078111

DOI=10.3389/fneur.2023.1078111

ISSN=1664-2295

ABSTRACT=Objective This randomized double-blinded clinical study is to investigate the clinical efficacy of per-paravertebral disc ozone injection combined with steroids in the treatment of patients with chronic discogenic low back pain (CDLBP). 
Methods Group A (N=60) received a per-paravertebral injection of a steroid mixture of 10 ml with pure oxygen 20 ml, while group B (N=60) received a per-paravertebral injection of a steroid mixture of 10 ml combined with ozone 20 ml (30 µg/mL). Injections were administered once a week for 3 weeks, with a follow-up of 6 months. Clinical outcomes were assessed at week 1, month 3, and month 6 with the help of Visual Analog Scale (VAS) scores and Macnab efficacy evaluation. 
Results The VAS score of both group A (1.65 vs 6.87, P=0.000) and group B (1.25 vs 6.85, P=0.000) at week 1 was significantly reduced compared to baseline. The effect was sustained at the 3- and 6-month follow-up periods (P<0.05). Group B had significantly lower VAS scores at month 3 (1.53 vs 3.82, P=0.000) and month 6 (2.80 vs 5.05, P=0.000) compared to group A, respectively. Based on Macnab criteria, 95% and 96.7% of patients in groups A and B had good rates “excellent plus good” at week 1, respectively. Good rates were significantly higher in group B at month 3 (91.7% vs 78.3%, P=0.041) and month 6 (85.0% vs 68.3%, P=0.031) compared to group A, respectively. No serious adverse events were noted in both groups. 
Conclusion Per-paravertebral injection of steroid and ozone combination resulted in better relief of CDLBP compared to pure oxygen plus steroid.