Low back and neck herniations (lumbar and cervical disc herniations) are conditions that significantly reduce quality of life, primarily through pain and restricted movement. Nowadays, less invasive alternatives to surgery for treating such herniations are increasingly preferred. Thanks to various approaches such as injections, ozone therapy, laser, and radiofrequency applications, patients can be treated without extended hospital stays and return to their daily lives quickly.
High Success Rates of Treatments, Low Complication Rates
Interventional Radiology Specialist Prof. Dr. Özgür Kılıçkesmez, who has conducted significant studies on non‑surgical treatments for low back and neck herniations, notes that these new‑generation methods have high success rates when patients are properly selected:
“Studies show that non‑surgical treatment approaches are effective in correctly selected patients. For example, patients receiving ozone therapy report up to a 75% reduction in pain and functional improvement. The same analyses indicate a complication rate as low as 0.1%. In laser disc decompression (PLDD), approximately 70% successful outcomes can be achieved in the appropriate patient group.”
Injections: Short‑Term Relief
Epidural steroid injections (ESI) are among the most commonly used methods for treating low back and neck herniations. These injections help relieve pain by reducing disc‑related inflammation. However, data on long‑term effects are limited:
“Although several large‑scale studies have proven that ESIs are effective in the short term, they do not completely eliminate pain in the long term. Therefore, injections are chosen to provide temporary relief, either in combination with other treatments or in the early stages of herniation.”
Ozone Therapy: Rapid Recovery and Low Side Effects
Ozone therapy involves injecting a mixture of oxygen and ozone directly into the affected area. It aims to relieve pressure on the nerve root by reducing pressure within the disc. Prof. Dr. Kılıçkesmez summarizes the advantages of ozone therapy as follows:
“Ozone therapy offers many advantages, such as rapid recovery, high success rates, and low complication risks. Because tissue damage is minimal during the procedure, patients can usually return to normal activities a few hours after treatment.”
Laser and Radiofrequency Applications: Targeted Intervention
Percutaneous Laser Disc Decompression (PLDD), also known as laser therapy, is based on reducing the pressure caused by the herniation by delivering laser energy into the disc through a small needle.
In radiofrequency applications, the goal is to reduce pain signals reaching the nerve roots or to create targeted thermal damage within the disc. Success rates for these methods range between 60% and 70%, with the patient’s clinical condition and the degree of herniation playing a decisive role in outcomes.
Spontaneous Regression Rate Nearly 63%
A comprehensive study on lumbar herniations found that approximately 63% of patients with symptomatic lumbar disc herniation experience spontaneous regression without any intervention. This finding underscores the importance of considering conservative (non‑surgical) treatment options before deciding on surgery.
“Of course, the same results cannot be expected for every patient. Factors such as herniation size, patient age, general health, and lifestyle directly affect outcomes,” says Prof. Dr. Kılıçkesmez.
“Many studies also emphasize that combining special exercise programs and manual therapy with medical treatment is more successful in relieving pain and improving function in the short term than medical treatment alone.”
Patients Should Make Informed Choices Before Surgery
Long‑term studies indicate that, for some patient groups, there is no significant difference between surgical and non‑surgical approaches for low back herniation for up to four years. This suggests that non‑surgical treatments can be as effective as surgery when applied with the correct indications.
“Patient selection, combined application of methods, and a multidisciplinary approach are key here. As with vascular issues, correct diagnosis and the appropriate treatment modality directly affect success in treating low back and neck herniations.”
Same‑Day Treatment and Discharge Possibility
Advances in interventional radiology often allow patients to receive treatment without interrupting their daily lives. These procedures, which can be performed in the angiography unit, are usually brief; the patient can return home the same day.
“In this comfortable process, the need for anesthesia is reduced, and recovery time is significantly shortened. However, for some patients, surgery may still be unavoidable; therefore, the best treatment plan should be determined collaboratively by the physician and patient.”
Prof. Dr. Özgür Kılıçkesmez emphasizes that the advantages of non‑surgical methods for treating low back and neck herniations are increasingly coming to the fore, and that the correct treatment option should be determined according to the patient’s clinical profile and lifestyle.
“Patients experiencing low back or neck herniation should learn about non‑surgical alternatives before considering surgery. In most cases, these treatments greatly alleviate pain and improve quality of life.”
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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