Analysis of disk volume before and after CT-guided intradiscal and periganglionic ozone-oxygen injection for the treatment of lumbar disk herniation

J Vasc Interv Radiol. 2012 Nov;23(11):1430-6. doi: 10.1016/j.jvir.2012.07.029. Epub 2012 Sep 20.


Purpose: To quantify the change in volume in herniated lumbar disk after computed tomography (CT)-guided intradiscal and periganglionic ozone-oxygen injection and to assess the effects of patient age, sex, and initial disk volume on disk volume changes.

Materials and methods: A total of 283 patients with lumbar radiculopathy received a single intradiscal (3 mL) and periganglionic (7 mL) injection of an ozone-oxygen mixture (ratio, 3:97; ozone concentration, 30 μg/mL). Under CT guidance, intradiscal and periganglionic injection was performed through an extraspinal lateral approach with a 22-gauge spinal needle. All disk volume changes were evaluated on CT 6 months after the procedure in all patients.

Results: Initial mean disk volume was 17.37 cm(3) ± 4.70 (standard deviation; range, 8.12-29.15 cm(3)). Disk volume reduction (mean, 7.70% ± 5.45; range, 0.29%-22.31%) was seen in 96.1% of treated disks (n = 272) at 6 months after treatment and was found to be statistically significant (P < .0001). In 3.9% of patients (n = 11), disk volume increased (mean, 0.59% ± 0.24; range, 0.11%-0.81%). Patient age correlated negatively with disk volume reduction (r = -0.505; P < .0001) at 6 months after treatment, whereas initial disk volume correlated positively with volume reduction (r = 0.225; P = .00014) after therapy. No correlation was noted between patient sex and disk volume reduction after treatment (P = .09).

Conclusions: Intradiscal administration of medical ozone is associated with a statistically significant volume reduction of the herniated lumbar disk. The volume-reduction effect of ozone correlates negatively with the patient's age and positively with initial disk volume.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Female
  • Humans
  • Injections, Spinal
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / drug effects*
  • Intervertebral Disc Chemolysis / methods*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / therapy*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / drug effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Ozone / administration & dosage*
  • Radiology, Interventional / methods*
  • Sex Factors
  • Time Factors
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Young Adult


  • Ozone