Comparison between paravertebral injections of ozone and epidural injections of corticosteroids used in the treatment of lumbosacral pain: scoping review

Paravertebral ozone injections have been used in the treatment of lumbosacral pain with or without radicular irradiation and have been reported to be effective in reducing pain when compared with placebo, physiotherapy programs or drug treatments; nevertheless, their effectiveness in comparison with minimally invasive procedures using corticosteroids is unknown. The main objective of this review was to explore the role of paravertebral ozone injections in the treatment of lumbosacral pain with radicular irradiation in comparison with minimally invasive procedures using corticosteroids. A systematic search was performed in electronic databases including PubMed, EMBASE, Central Cochrane and Web of Science, from January 2000 to December 2024; for clinical studies that compared paravertebral ozone injections with minimally invasive procedures using corticosteroids in the treatment of lumbosacral pain with radicular irradiation and were performed using the methodology of a scoping review. Four clinical trials met the inclusion criteria and were included in this review, gathering a total of 501 individuals. In the within-group comparison of every study, statistically significant reduction in pain was observed in both interventions. No side effects or serious adverse reactions were reported in the treated patients. Paravertebral ozone injections appear to have a favorable therapeutic effect in reducing pain in the short and medium terms, in individuals with lumbosacral pain with radicular irradiation, and this effect appears to be similar to that of epidural corticosteroid injections. No definitive recommendations are possible, for more clinical trials are needed to conduct meta-analytic reviews that clarify the results of this comparison.