To assess the clinical efficiency of intraforaminal and intradiscal injection of a combination of steroids, local anaesthetic and oxygen-ozone (O2-O3) mixture (chemodiscolysis) vs. intraforaminal and intradiscal injection of steroids and anaesthetic in the management of radicular pain related to acute lumbar disc herniations.

The study protocol was approved by the medical ethical committee of our institution. 139 consecutive patients (75 M, 64 F; aged 18-71 years) entered the study. Inclusion criteria : monoradicular pain, lumbar disc herniation shown by CT or MRI, herniation site congruous with the neurological level, and Oswestry disability index over 30%. All patients complained of pain since at least 8 weeks and they had been submitted to conservative therapy for 2-4 weeks, with no or poor clinical improvement. Patients with major neurological deficits and...

In group A, treatment was successful in 32 patients (48.5%) after six months, while in group B treatment was successful in 54 patients (74.0%) after six months (tab. 1). The difference between group A and group B was significant (P<0.01). No complications were reported. No outcome differences were found between paravertebral and interlaminar access.

Intraforaminal and intradiscal injection of steroids, anaesthetics and O2-O3 is most effective than the injection of only steroids and anaesthetics in the same sites. O2-O3 chemodiscolysis is an useful toll for treatment of pain and sciatica caused by acute lumbar disc herniation. The procedure is fast, easy to perform and safe for the patient.

1. Andreula CF, Simonetti L, De Santis F, Agati R, Ricci R, Leonardi M. Minimally Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation. AJNR Am J Neuroradiol 2003; 24: 996-1000. 2. Bonetti M, Fontana A, Cotticelli B, Volta GD, Guindani M, Leonardi M (2005) Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR Am J Neuroradiol 26; 996-1000. 3. Carette S, Leclaire R, Marcoux S, et al. Epidural corticosteroid injections for sciatica due to herniated nucleus polposus. N. Engl J Med...

All Authors come from: Derartment of Radiology, Hospital S.Salvatore, University of L'Aquila, L'Aquila, Italy Corresponding Author: Nicola Limbucci, Dept. of Radiology, Hospital S.Salvatore, Coppito, 67100 L'Aquila, Italy E-mail: [email protected] www.radaq.it