Efficacy and safety of low-temperature plasma radiofrequency ablation combined with ozone injection versus triple therapy including collagenase for cervical disc herniation: a randomized controlled trial.

Abstract

To compare the efficacy and safety of low-temperature plasma radiofrequency ablation combined with ozone injection versus the same dual therapy with additional collagenase for cervical disc herniation (CDH). A prospective RCT enrolled 90 eligible CDH patients (30-80 years, single-level protrusion ≤ 1/3 spinal canal) at a tertiary hospital, randomizing them to a study group (n = 45, triple therapy) or control group (n = 45, low-temperature plasma radiofrequency ablation + ozone). Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores were compared preoperatively and at 1 week, 1, 3, and 6 months postoperatively, with efficacy assessed via Modified MacNab Criteria. At 6 months, the study group showed significantly better VAS and JOA scores (P < 0.05) and a 6-month excellent rate of 93.33% vs. 75.56% in controls (P < 0.05). Both groups improved postoperatively, with no early differences. No severe adverse events occurred. The addition of collagenase to ablation and ozone therapy significantly enhances long-term pain relief and functional recovery in CDH patients without increasing safety risks.