Hosseini Behnam, Taheri Mehrdad, Sheibani Kourosh
1 Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Basir Eye Health Research Center, Basir Eye Clinic, Tehran, Iran.
Interv Neuroradiol. 2019 Feb;25(1):111-116. doi: 10.1177/1591019918800458. Epub 2018 Sep 18.
To evaluate the therapeutic efficacy of intradiscal ozone injection in reducing pain and improving patients' performance in different types of intervertebral disc herniation based on Michigan State University (MSU) classification.
Consecutive patients with low back pain and radiculopathy treated in our center with ozone chemonucleolysis from May 2017 through to January 2018 entered the study. Patients had a disc herniation classified as group 1-A, 2-A, 1-B, 2-B, 1-C, 2-C, 1-AB or 2-AB based on MSU classification in magnetic resonance imaging. In all patients entering the study the severity of pain was recorded according to the visual analog scale criteria before and one and three months after the end of treatment. Oswestry Low Back Pain Disability Index (ODI) was used to compare patients' performance before and after the treatment.
In total 128 patients (60 females and 68 males) with mean age of 40.1 ± 10.7 entered the study. The patients were divided into eight groups based on MSU classification each including 16 patients. The reduction of pain severity and ODI score compared to baseline was statistically significant in all groups both in the first month and the third month after treatment. There was also a statistically significant difference between groups regarding the reduction of pain and ODI score indicating significantly worse treatment outcomes in groups 1-C, 2-C and 2-AB.
Based on our findings it seems that MSU classification can be used in patients' selection to achieve the best treatment outcome after intradiscal ozone injection among patients with lumbar disc herniation.
基于密歇根州立大学（MSU）分类法，评估椎间盘内注射臭氧在减轻不同类型椎间盘突出症患者疼痛及改善其功能方面的治疗效果。
选取2017年5月至2018年1月在本中心接受臭氧化学髓核溶解术治疗的连续性下腰痛和神经根病患者进入研究。患者在磁共振成像中根据MSU分类法被分为1 - A、2 - A、1 - B、2 - B、1 - C、2 - C、1 - AB或2 - AB组。所有进入研究的患者在治疗结束前及结束后1个月和3个月时，根据视觉模拟量表标准记录疼痛严重程度。采用Oswestry下腰痛功能障碍指数（ODI）比较患者治疗前后的功能表现。
共有128例患者（60例女性和68例男性）进入研究，平均年龄为40.1±10.7岁。根据MSU分类法将患者分为8组，每组16例。治疗后第1个月和第3个月，所有组的疼痛严重程度降低及ODI评分与基线相比均有统计学意义。在疼痛减轻和ODI评分降低方面，组间也存在统计学差异，表明1 - C、2 - C和2 - AB组的治疗效果明显较差。
基于我们的研究结果，似乎MSU分类法可用于腰椎间盘突出症患者的选择，以在椎间盘内注射臭氧后获得最佳治疗效果。
