Trial comparing intra-discal injection of ozone with platelet rich plasma (PRP) versus corticosteroid injection around the nerve versus surgical disc removal in patients suffering sciatica due to a lumbar disc herniation.

The following intervention is used once only. CT or fluoroscopy guided Oxygen Ozone and platelet rich plasma (PRP) intradiscal injections: A radiologist with more than five years consultant experience performs an intradiscal injection of 4cc of Oxygen Ozone 27microgram/ml, 6cc of peridiscal injection of O2O3, 1-3cc of autologous blood derived platelet rich plasma (PRP) into the disc and 3cc around the disc. The standard technique of injection into the nucleus pulposus with slow withdrawal of needle into the annulus and peri-annular space is performed for both ozone and PRP. A total of 6cc of PRP is used into and around the disc. This may be performed in an outpatient CT facility if all of the following are fulfilled: patients are observed in the supine and decubitus position for two hours. The patient is only discharged with an escort. CT or fluoroscopy guidance is used at the discretion of the proceduralist. PRP is typically obtained by a standard venesection with collection of 8cc of venous blood into a sterile blood collection tube (e.g. ADISTEM tubes or similar tubes approved by the Therapeutic Goods Administration of Australia for this purpose) that contains 1-2cc of sodium citrate as an anticoagulant. This is centrifuged for 5 minutes. The blood collection tube is then transferred to a clean air flow cabinet (or in the open if performed in a theatre), where the Buffy coat supernatant is aspirated into a sterile syringe in a sterile fashion for injection.