Bisshopp Sara, Linertová Renata, Caramés Miguel A, Szolna Adam, Jorge Ignacio J, Navarro Minerva, Melchiorsen Brian, Rodríguez-Díaz Benjamín, González-Martín Jesús M, Clavo Bernardino
Neurosurgery, Dr. Negrín University Hospital, 35019 Las Palmas, Spain.
Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain.
J Clin Med. 2025 Jun 26;14(13):4534. doi: 10.3390/jcm14134534.
: Surgery is the treatment of choice for symptomatic disc herniation after unsuccessful conservative management. This prospective study compared the impact on clinical and hospital outcomes of intradiscal ozone treatment vs. surgery (microdiscectomy/discectomy) in our clinical practice. : Intradiscal ozone treatment was offered to 70 patients with scheduled surgery because of lumbar disc herniation. Initial treatment was surgery in 38 patients and ozone infiltration in 32 patients: lumbar and sciatic pain (Visual Analog Scale), Roland-Morris Disability Questionnaire score, days of hospital admission, and direct hospital costs were recorded during 24 months of follow-up. : At 12 and 24 months, lumbar pain, sciatic pain, and Roland-Morris score decreased significantly within both groups ( < 0.001). At 24 months, compared to the initial surgery, the initial intradiscal ozone treatment showed similar clinical outcomes with significantly lower requirements of surgery (100% versus 47%, < 0.001) and lower hospital stay [median 2.5 (2-3) versus 0.5 (0-2) days, < 0.001]. Direct hospital costs were significantly lower with initial ozone treatment at 12 months ( = 0.040). : In our real-world prospective study, after 24 months of follow-up, initial intradiscal ozone treatment avoided surgery in more than half of patients and provided similar clinical outcomes with lower hospitalization requirements. In patients with lumbar disc herniation requiring surgery (microdiscectomy/discectomy), initial intradiscal ozone treatment could offer benefits for patients and healthcare service providers (NCT00566007).
对于保守治疗失败的有症状椎间盘突出症，手术是首选治疗方法。本前瞻性研究在我们的临床实践中比较了椎间盘内臭氧治疗与手术（显微椎间盘切除术/椎间盘切除术）对临床和医院结局的影响。：因腰椎间盘突出症计划手术的70例患者接受了椎间盘内臭氧治疗。38例患者初始治疗为手术，32例患者为臭氧浸润：在24个月的随访期间记录腰痛和坐骨神经痛（视觉模拟评分）、罗兰-莫里斯残疾问卷评分、住院天数和直接住院费用。：在12个月和24个月时，两组患者的腰痛、坐骨神经痛和罗兰-莫里斯评分均显著降低（<0.001）。在24个月时，与初始手术相比，初始椎间盘内臭氧治疗显示出相似的临床结局，但手术需求显著更低（100%对47%，<0.001），住院时间更短[中位数2.5（2 - 3）天对0.5（0 - 2）天，<0.001]。在12个月时，初始臭氧治疗的直接住院费用显著更低（=0.040）。：在我们的真实世界前瞻性研究中，经过24个月的随访，初始椎间盘内臭氧治疗使超过一半的患者避免了手术，并提供了相似的临床结局，住院需求更低。对于需要手术（显微椎间盘切除术/椎间盘切除术）的腰椎间盘突出症患者，初始椎间盘内臭氧治疗可为患者和医疗服务提供者带来益处（NCT00566007）。
