Top 10 Research Articles: Clinical Evidence for Intradiscal Ozone Therapy

Introduction

Intradiscal ozone therapy is a minimally invasive treatment that is increasingly supported by peer-reviewed clinical research for disc herniation, chronic back pain, and radiculopathy. Below are 10 of the most significant research articles, selected for their high-quality methodology, long-term outcomes, and real-world relevance to patient care.

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1. Five and Ten Year Follow-Up on Intradiscal Ozone Injection for Disc Herniation (2015)

📄 Read Full Text (International Journal of Spine Surgery)

Authors: Buric J, Rigobello L, Hooper D

Key Findings:

• 75% of patients experienced lasting relief for up to 10 years
• Consistent MRI-documented reduction in disc size
• Avoidance of surgery and repeated epidural injections

Clinical Significance:

This is the longest available follow-up study on ozone therapy, showing it can offer durable relief without compromising future surgical options.

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2. Effectiveness of Intradiscal Ozone Injections: Systematic Review and Meta-Analysis (2024)

📄 Read Abstract (Journal of Back and Musculoskeletal Rehabilitation)

Authors: Chang MC, Choo YJ, Denis I, Mares C, Majdalani C, Yang S

Key Findings:

• Superior to steroids and oral meds in long-term (≥6 months) outcomes
• Confirmed statistically significant improvements across multiple studies

Clinical Significance:

This latest comprehensive analysis confirms ozone therapy outperforms conventional treatments in long-term pain relief and mobility.

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3. Intradiscal Oxygen-Ozone Chemonucleolysis vs. Microdiscectomy: Non-Inferiority Trial (2022)

📄 Read Abstract (The Spine Journal)

Authors: Kelekis A, Bonaldi G, Cianfoni A, et al.

Key Findings:

• Ozone was non-inferior to surgery in pain relief at 6 months
• 71% of patients avoided surgery entirely
• Similar rapid improvement in both groups

Clinical Significance:

This RCT is a landmark trial showing ozone therapy is as effective as surgery without the surgical risks.

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4. Medical Ozone as a Therapeutic Option in Musculoskeletal Pain Control: Critical Review (2024)

📄 Read Full Article (Yale Journal of Biology and Medicine)

Authors: de Araújo LT, da Silva PC, Masini M

Key Findings:

• 92% of reviewed studies showed no adverse effects
• Effective across a wide range of musculoskeletal pain conditions
• High safety and cost-effectiveness profile

Clinical Significance:

This 2024 review validates ozone as a low-risk, high-reward therapy in pain medicine.

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5. Efficacy of Intradiscal Ozone Therapy vs Steroid Injection: Double-Blind Study (2020)

📄 Read Abstract (Pain Physician)

Authors: Ercalik T, Kilic M

Key Findings:

• Ozone alone was sufficient for treating low back and leg pain
• No added benefit from combining with steroids
• Supports simpler, safer treatment protocols

Clinical Significance:

This RCT reinforces that ozone therapy as monotherapy is highly effective, reducing the need for corticosteroids.

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6. Andreula C. et al. (2003) — “Minimally Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation”

📄 Read on AJNR

Key Findings:

• Treated over 600 patients
• 70–80% success rate
• Very low complication rate

Clinical Significance:

This seminal study helped launch widespread clinical interest in intradiscal ozone in Europe.

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7. Bonetti M. et al. (2005) — “O2-O3 vs. Steroid Injections for Sciatica”

📄 View Full Text (AJNR)

Key Findings:

• Ozone more effective than steroids
• Fewer side effects and longer-lasting relief

Clinical Significance:

Proved that ozone is superior to standard epidural steroid injections in sciatica caused by herniated discs.

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8. Magalhães FN. et al. (2012) — “Systematic Review of Ozone Therapy for Lumbar Disc Herniation”

📄 Read Full Text (Pain Physician)

Key Findings:

• Reviewed 12 studies
• Confirmed safety and efficacy
• Statistically significant improvements in pain and function

Clinical Significance:

This paper helped standardize evidence-based use of ozone therapy globally.

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9. Gallucci M. et al. (2007) — “Imaging-Guided Ozone Therapy”

📄 Read Abstract (European Spine Journal)

Key Findings:

• High precision under CT/fluoroscopy guidance
• Effective in outpatient spine management

Clinical Significance:

Highlights the importance of imaging-guidance to maximize safety and outcomes.

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10. Buric J. et al. (2011) — “Oxygen-Ozone Therapy vs Conservative Treatment”

📄 Read Abstract (Acta Neurochirurgica Supplement)

Key Findings:

• Randomized controlled trial
• Ozone group saw greater pain and mobility improvements

Clinical Significance:

Supports ozone therapy as a frontline treatment for lumbar disc herniation.

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Conclusion

These 10 top studies, ranging from randomized trials to systematic reviews and 10-year follow-ups, present a strong clinical case for intradiscal ozone therapy as a viable alternative to spinal surgery and long-term drug use. With growing global acceptance and proven long-term outcomes, ozone therapy is a powerful option in non-surgical spine care.

Dr. A Disc Care is proud to offer this safe, evidence-based treatment using the latest image-guided protocols. Schedule a consultation today or view our other services.