Comparing the results of intradiscal ozone injection to treat different types of intervertebral disc herniation based on MSU classification

Abstract

Purpose: To evaluate the therapeutic efficacy of intradiscal ozone injection in reducing pain and improving patients’ performance in different types of intervertebral disc herniation based on Michigan State University (MSU) classification. Patients and methods: Consecutive patients with low back pain and radiculopathy treated in our center with ozone chemonucleolysis from May 2017 through to January 2018 entered the study. Patients had a disc herniation classified as group 1-A, 2-A, 1-B, 2-B, 1-C, 2-C, 1-AB or 2-AB based on MSU classification in magnetic resonance imaging. In all patients entering the study the severity of pain was recorded according to the visual analog scale criteria before and one and three months after the end of treatment. Oswestry Low Back Pain Disability Index (ODI) was used to compare patients’ performance before and after the treatment. Results: In total 128 patients (60 females and 68 males) with mean age of 40.1 ± 10.7 entered the study. The patients were divided into eight groups based on MSU classification each including 16 patients. The reduction of pain severity and ODI score compared to baseline was statistically significant in all groups both in the first month and the third month after treatment. There was also a statistically significant difference between groups regarding the reduction of pain and ODI score indicating significantly worse treatment outcomes in groups 1-C, 2-C and 2-AB. Conclusion: Based on our findings it seems that MSU classification can be used in patients’ selection to achieve the best treatment outcome after intradiscal ozone injection among patients with lumbar disc herniation.