Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study

Bisshopp, Sara; Linertová, Renata; Caramés, Miguel A.; Szolna, Adam; Jorge, Ignacio J.; Navarro, Minerva; Melchiorsen, Brian; Rodríguez-Díaz, Benjamín; González-Martín, Jesús M.; Clavo, Bernardino

doi:10.3390/jcm14134534

Open AccessArticle

Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study

by

Sara Bisshopp

^1,2,3,

Renata Linertová

^2,4,5,6,*

,

Miguel A. Caramés

⁷,

Adam Szolna

¹,

Ignacio J. Jorge

⁷,

Minerva Navarro

⁷,

Brian Melchiorsen

¹,

Benjamín Rodríguez-Díaz

^2,4,5,

Jesús M. González-Martín

^2,8,9

and

Bernardino Clavo

^{2,3,7,8,9,10,*}

¹

Neurosurgery, Dr. Negrín University Hospital, 35019 Las Palmas, Spain

²

Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain

³

Grupo BioPharm, Spain Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain

⁴

Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, 38109, Spain

⁵

The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28014 Madrid, Spain

⁶

Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain

⁷

Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas, Spain

⁸

Research Unit, Dr. Negrín University Hospital, 35019 Las Palmas, Spain

⁹

Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain

¹⁰

CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain

^*

Authors to whom correspondence should be addressed.

J. Clin. Med. 2025, 14(13), 4534; https://doi.org/10.3390/jcm14134534

Submission received: 28 May 2025 / Revised: 17 June 2025 / Accepted: 20 June 2025 / Published: 26 June 2025

(This article belongs to the Section Orthopedics)

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Abstract

Background/Objectives: Surgery is the treatment of choice for symptomatic disc herniation after unsuccessful conservative management. This prospective study compared the impact on clinical and hospital outcomes of intradiscal ozone treatment vs. surgery (microdiscectomy/discectomy) in our clinical practice. Methods: Intradiscal ozone treatment was offered to 70 patients with scheduled surgery because of lumbar disc herniation. Initial treatment was surgery in 38 patients and ozone infiltration in 32 patients: lumbar and sciatic pain (Visual Analog Scale), Roland-Morris Disability Questionnaire score, days of hospital admission, and direct hospital costs were recorded during 24 months of follow-up. Results: At 12 and 24 months, lumbar pain, sciatic pain, and Roland-Morris score decreased significantly within both groups (p < 0.001). At 24 months, compared to the initial surgery, the initial intradiscal ozone treatment showed similar clinical outcomes with significantly lower requirements of surgery (100% versus 47%, p < 0.001) and lower hospital stay [median 2.5 (2–3) versus 0.5 (0–2) days, p < 0.001]. Direct hospital costs were significantly lower with initial ozone treatment at 12 months (p = 0.040). Conclusions: In our real-world prospective study, after 24 months of follow-up, initial intradiscal ozone treatment avoided surgery in more than half of patients and provided similar clinical outcomes with lower hospitalization requirements. In patients with lumbar disc herniation requiring surgery (microdiscectomy/discectomy), initial intradiscal ozone treatment could offer benefits for patients and healthcare service providers (NCT00566007).

Keywords: costs; discectomy or microdiscectomy; disc herniation; intradiscal ozone therapy; lumbar pain; radicular pain

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MDPI and ACS Style

Bisshopp, S.; Linertová, R.; Caramés, M.A.; Szolna, A.; Jorge, I.J.; Navarro, M.; Melchiorsen, B.; Rodríguez-Díaz, B.; González-Martín, J.M.; Clavo, B. Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study. J. Clin. Med. 2025, 14, 4534. https://doi.org/10.3390/jcm14134534

AMA Style

Bisshopp S, Linertová R, Caramés MA, Szolna A, Jorge IJ, Navarro M, Melchiorsen B, Rodríguez-Díaz B, González-Martín JM, Clavo B. Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study. Journal of Clinical Medicine. 2025; 14(13):4534. https://doi.org/10.3390/jcm14134534

Chicago/Turabian Style

Bisshopp, Sara, Renata Linertová, Miguel A. Caramés, Adam Szolna, Ignacio J. Jorge, Minerva Navarro, Brian Melchiorsen, Benjamín Rodríguez-Díaz, Jesús M. González-Martín, and Bernardino Clavo. 2025. "Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study" Journal of Clinical Medicine 14, no. 13: 4534. https://doi.org/10.3390/jcm14134534

APA Style

Bisshopp, S., Linertová, R., Caramés, M. A., Szolna, A., Jorge, I. J., Navarro, M., Melchiorsen, B., Rodríguez-Díaz, B., González-Martín, J. M., & Clavo, B. (2025). Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study. Journal of Clinical Medicine, 14(13), 4534. https://doi.org/10.3390/jcm14134534

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Pain Relief, Disability, and Hospital Costs After Intradiscal Ozone Treatment or Microdiscectomy for Lumbar Disc Herniation: A 24-Month Real-World Prospective Study

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