Effectiveness of ozone nucleolysis in alleviating pain and enhancing function in lumbar sciatica due to disc herniation: a minimally invasive approach

Ozone (O₂-O₃) nucleolysis is emerging as a promising minimally invasive therapy for treating lumbosciatica due to herniated discs. This study aims to evaluate changes in pain and functional abilities before and after ozone disc nucleolysis in patients with lumbar disc herniation (LDH).

This study included 34 patients (15 males, 19 females; age range 17–76, average age 46.7 ± 11.2 years) treated between April 2018 and May 2022. A single dose of an O₂-O₃ mixture (5 ml, 30 µg/ml) was injected into the disc under fluoroscopic guidance via a lateral approach, followed by an additional periradicular injection of the same mixture (5 ml) combined with a corticosteroid (2 ml). Pain and patient satisfaction were assessed using the VAS score and modified MacNab criteria, while MRI findings evaluated treatment-related changes, including herniated disc surface and disc height.

VAS scores indicated pain improvement in 85% of patients, with 82% achieving satisfactory outcomes per modified MacNab criteria. Patients under 50 years of age showed greater responsiveness to ozone therapy. Central LDH responded more favorably than larger foraminal herniations, and hernias with a larger surface area than the average also showed better outcomes. No complications were observed.

Ozone therapy is a cost-effective, simple, and safe minimally invasive technique that provides significant pain relief and functional improvement. It may be a reliable and competitive treatment option for patients with persistent symptoms after conservative treatment and before considering surgical intervention.