Efficacy and safety of CT-guided oxygen-ozone (O₂-O₃) therapy for low back pain: a retrospective single-center study

Oxygen-ozone (O₂-O₃) therapy is increasingly recognized as a minimally invasive option for managing low back pain (LBP). This study aims to assess the efficacy and safety of CT-guided O₂-O₃ injections, both as a standalone therapy and in combination with other medications, across a diverse cohort of patients with LBP.

We conducted a single-center retrospective observational study of patients with LBP who underwent CT-guided O₂-O₃ intradiscal and/or facet joint injections between January 2016 and March 2017. Patients were categorized into three groups: Group A (facet joint osteoarthritis), Group B (single-level disc herniation with unilateral sciatica), and Group C (double-level disc herniation with bilateral or unilateral sciatica). Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline and three weeks after the final injection. Statistical analysis included paired t-tests for pre- and post-treatment comparisons and one-way ANOVA with Tukey's HSD for group comparisons.

A total of 123 patients were included. The mean baseline VAS score for the entire cohort was 7.5 ± 1.2, which significantly decreased to 3.5 ± 1.5 following treatment (T = 43.74, p < 0.001). In Group A, the mean VAS decreased from 7.2 ± 1.3 to 3.8 ± 1.4; in Group B, from 7.8 ± 1.0 to 3.2 ± 1.3; and in Group C, from 8.0 ± 0.9 to 3.0 ± 1.2. ANOVA revealed significant differences in post-treatment VAS scores among groups (F = 27.36, p < 0.001). Tukey's HSD indicated significant differences between Groups A and B (p < 0.001) and A and C (p < 0.001), with no significant difference between Groups B and C (p = 0.247). Overall, 21.95% of patients experienced significant improvement (VAS reduction > 4 points), 57.72% had moderate improvement (VAS reduction 2-4 points), and 18.7% showed minimal improvement (VAS reduction ≤ 1 point). No complications were reported during or after the procedures.

The findings strongly support the efficacy and safety of O₂-O₃ therapy for the treatment of LBP, offering significant short-term pain relief across diverse patient subgroups. Further controlled studies are warranted to confirm long-term efficacy and optimize treatment protocols.