OBJECTIVETo evaluate the effect of targeted percutaneous injection of medical ozone through the posterior approach via the spinal canal and dural sac under CT guidance for treatment of lumbar disc herniation.

METHODSIn 262 patients with lumbar disc herniation, medical ozone was injected percutaneously under CT guidance into the lumbar intervertebral disc by the posterior approach at paramedian 1-2 cm from the spinous process, targeting the affected lumbar discs, protruded nucleus pulposus and ipsilateral lateral recess. The concentration of ozone was 40-50 µg/ml in the disc/protruded nucleus pulposus and 30 µg/ml in the lateral recess (around the nerve root).

RESULTSThe treatment procedures were successfully completed in all the 262 patients. The average scores of JOA and VAS before treatment were 8.30∓1.4 and 8.73∓0.8, and changed significantly to 24.16∓3.2 (P=0.0158) and 2.41∓0.2 (P=0.0242) after treatment, respectively. According to the modified MacNab criteria, the therapeutic effect was excellent in 165 cases, fair in 64 cases, acceptable in 20 cases, and poor in 13 cases, with a total success rate of 87.4%. No patient showed serious complications after the treatment.

CONCLUSIONCompared with routine ozone therapy by the posterior-lateral approach, targeted percutaneous ozone injection into the intervertebral disc by the modified posterior approach is safe and yields better therapeutic effect for lumbar disc herniation.