The Effect of Lumbar Spinal Surgery History on Intradiscal O(2)–O(3) Treatment Results in Patients with Lumbar Disk Herniation

OBJECTIVES: The aim of the present study was to investigate the effect of previous spinal surgery on intradiscal ozone–oxygen (O(2)–O(3)) treatment in low back pain associated with lumbar disc herniation (LDH). METHODS: Patients who underwent intradiscal O(2)–O(3) therapy for LDH-induced low back pain were screened retrospectively from hospital records. To ensure homogenization of participants, patients who had received O(2)–O(3) therapy to L4–L5 and L5–S1 intervertebral discs, those with pre-injection and post-injection month 1 data, and those who completed the first year of treatment were included in the study. Patients who completed the first year of treatment but with missing data were contacted and followed up by phone. Patients who underwent surgery at the same level as the injection level were classified as Group 1 (n=30), and those without surgery were classified as Group 2 (n=43). Pain and disability were measured by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), respectively. RESULTS: There was no statistically significant difference between the pre-injection VAS and ODI scores of the groups (p=0.719 and p=0.108). Group 1 had significantly higher VAS and ODI scores on month 1 and year 1 than Group 2, and statistically significant decreases were seen in VAS and ODI scores in both groups at follow-up (p<0.001 for all). There was no statistically significant difference between month 1 and year 1 VAS evaluations of the groups with respect to ≥50% improvement in pain reduction (p=0.213 and p=0.347). CONCLUSION: In the present study, the effect of the history of spinal surgery on intradiscal O(2)–O(3) treatment results was investigated. Intradiscal injection was found to be effective for both groups, but more successful results were obtained in patients without surgical history.