Efficacy of ozone with steroid injection therapy in lumbar disc herniation: meta-analysis.

BACKGROUND: The efficacy of ozone combined with steroid injection for lumbar disc herniation remains uncertain. This systematic review and meta-analysis aimed to investigate the efficacy of Ozone with steroid injection therapy in the treatment of lumbar disc herniation. METHODS: PubMed, Embase, Web of Science, and Wanfang were searched from database inception to July 20, 2026. Comparative studies evaluating ozone combined with steroid injection in patients with lumbar disc herniation were included. Mean differences (MDs) were used for continuous outcomes, and odds ratios (ORs) were used for dichotomous outcomes, with corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran's Q test and the I 2 statistic. RESULTS: Seven comparative studies involving 751 patients were included. Meta-analysis showed that Ozone combined with steroid injection was associated with a greater reduction in pain intensity than control interventions (MD = -2.27, 95% CI: -2.57 to -1.97). The combined treatment was also associated with a higher study-defined treatment success rate (OR = 3.84, 95% CI: 2.56 to 5.77). However, no statistically significant between-group difference was observed in Oswestry Disability Index (ODI) (MD = -0.51, 95% CI: -2.82 to 1.81). Safety reporting was limited, precluding quantitative synthesis of adverse events. CONCLUSIONS: Ozone combined with steroid injection may improve pain intensity and treatment success in patients with lumbar disc herniation, but its additional benefit for functional disability remains uncertain. Given the limited number of studies, mixed study designs, and heterogeneous treatment protocols, the findings should be considered preliminary and interpreted cautiously.