Computed tomography-guided oxygen–ozone injection for the treatment of lumbar disc herniation complicated with lumbar spinal stenosis

JOURNAL/mgres/04.03/01612956-202609000-00003/figure1/v/2026-01-06T135433Z/r/image-tiff Lumbar disc herniation complicated by lumbar spinal stenosis is a common degenerative condition in spinal surgery, particularly among middle-aged and elderly individuals. Conservative treatments or open surgery are commonly used but often have limited efficacy or significant risks, especially in older patients. Oxygen-ozone therapy, known for its mechanical decompression, anti-inflammatory, analgesic, and neuroprotective effects, is gaining attention as a minimally invasive treatment for lumbar disc herniation, offering an alternative to traditional treatments. Therefore, this study aimed to evaluate the clinical therapeutic effect of computed tomography-guided percutaneous oxygen-ozone injection on lumbar disc herniation complicated by lumbar spinal stenosis. This retrospective study analyzed the clinical outcomes of 47 patients with lumbar disc herniation complicated by lumbar spinal stenosis who were treated between September 2023 and February 2024. Patients were divided into two groups: the ozone group received computed tomography-guided percutaneous oxygen-ozone injection ( n = 25), and the caudal epidural steroid injection group underwent ultrasound-guided ( n = 22). Pain relief and functional outcomes were assessed preoperatively and at 1 day, 1 month, 3 months, and 6 months postoperatively using the visual analog scale, and Oswestry Disability Index and modified MacNab criteria. Both groups showed significant reduction in visual analog scale and Oswestry Disability Index at 1 day and 1 month postoperatively compared with preoperatively ( P < 0.05), with the ozone group demonstrating more pronounced improvements than the caudal epidural steroid injection group. At 3 months, although further improvement was observed in both groups, the differences in visual analog scale and Oswestry Disability Index between the two groups were not statistically significant ( P > 0.05). By 6 months, the ozone group showed significantly greater improvements than the caudal epidural steroid injection group ( P < 0.05). The total effective rate based on modified MacNab criteria increased over time in both groups. Although the ozone group exhibited a slightly higher rate, the difference was not statistically significant ( P > 0.05). Computed tomography-guided oxygen-ozone injection provides sustained pain relief and functional recovery in lumbar disc herniation with lumbar spinal stenosis, demonstrating superior long-term efficacy to epidural steroids.