Ozone and PRP Injections for Symptomatic Lumbar Herniated Disc

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Low back pain from arthritic lumbar facet joints and painful degenerative lumbar discs is widespread and one of the world's most disabling diseases, consuming significant health care resources. In this chapter, the authors report using autologous platelet-rich plasma (PRP) and ozone spinal injections into arthritic lumbar facet joints and painful lumbar degenerative discs to treat inflammatory pain. A prospective observational cohort study from January 2016 to March 2020 was performed at an outpatient clinic of a single academic medical center to assess these injections' safety and therapeutic effectiveness in conjunction with epidural transforaminal epidural steroid injections. Results indicated functional improvements measured by Oswestry Disability Index (ODI) and modified MacNab criteria and pain measured by visual analog scale leg pain (VAS) at rest and during flexion. Although our study was limited in scope, and by the observational nature of our research and the lack of randomized and double-blinding, our work suggests that rapid pain reduction and functional gains may materialize in patients with low back pain due to herniated disc after spinal injections with ozone and activated PRP.