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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:996-1000, May 2005
© 2005 American Society of Neuroradiology

SPINE

Intraforaminal O₂-O₃ versus Periradicular Steroidal Infiltrations in Lower Back Pain: Randomized Controlled Study

Matteo Bonetti^a, Alessandro Fontana^a, Biagio Cotticelli^b, Giorgio Dalla Volta^a, Massimiliano Guindani^b and Marco Leonardi^c

^a Department of Neuroradiology and Division of Neurology, Istituto Clinico Città di Brescia, Italy
^b Division of Neurology, Casa di Cura S. Anna, Italy
^c Department of Neuroradiology Ospedale Bellaria, Bologna, Italy

Address reprint requests to Dr Matteo Bonetti, Servizio di Neuroradiologia, Istituto Clinico Città di Brescia, Via Gualla 15, I–25123 Brescia, Italy

BACKGROUND AND PURPOSE: Reports about steroids and oxygen-ozone therapy to treat lower back pain have been increasing. The purpose of our study was to compare the clinical outcomes in patients treated with infiltrations of O₂-O₃ gas or steroids at short-, medium-, and long-term follow-up.

METHODS: A total of 306 patients (166 with primarily disk disease, 140 with nondisk vertebral disease) with acute or chronic low back and sciatic nerve pain received a CT-guided intraforaminal infiltration of an O₂-O₃ gas mixture or an periradicular infiltration of steroids. Neurologists unaware of the type of treatment assessed the patients.

RESULTS: At 1-week follow-up, most patients had a complete remission of pain, regardless of the treatment. At 6-month follow-up, differences in favor of O₂-O₃ treatment were significant in patients with disk disease (P = .0021) but not in those without disk disease (P = .0992). Clinical outcomes were poor in 13 (15.1%) of 86 patients receiving O₂-O₃ infiltration and in 18 (22.5%) of 80 patients receiving steroid injection (P = .2226). Among patients without disk disease, six (8.6%) of 70 patients receiving O₂-O₃ infiltration but 21.4% of the patients receiving steroid injections had poor outcomes (P = .0332).

CONCLUSION: Oxygen-ozone treatment was highly effective in relieving acute and chronic lower back pain and sciatica. The gas mixture can be administered as a first treatment to replace epidural steroids.

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