Lumbar disc herniation is a common and frequent disease and is the most common cause of back and leg pain. Image-guided minimally invasive treatment for lumbar disc herniation is less invasive, less painful, faster recovery and less complications is now widely used in clinical practice and has become the preferred method for the treatment of mild and moderate lumbar disc herniation. For lumbar pain caused by lumbar disc herniation, the efficiency of conservative treatment such as bed rest, lumbar traction, massage and epidural closure is 80% to 90%, but some patients still need surgery. Conventional surgical procedures such as total laminectomy and hemilaminectomy are very invasive, have long recovery time, and have many complications. With the development of interventional radiology, minimally invasive treatment of disc herniation is increasingly accepted by patients. The mechanism of action of medical ozone treatment for lumbar disc herniation: ozone can work through a variety of mechanisms: 1, mechanical mechanism ozone can directly oxidize the nucleus pulposus proteoglycans; combined with the water in the nucleus pulposus matrix to generate reactive oxygen species, ROS destroy the proteoglycan complex of amino acids and -OH groups in the double bond resulting in the nucleus pulposus matrix osmotic pressure The nucleus pulposus becomes dehydrated and the disc tissue atrophies, thus relieving the compression of the nerve root by the disc. Ozone causes apoptosis of the nucleus pulposus by destroying unsaturated fatty acids, cholesterol and other protein groups in the cell membrane, altering the permeability of the cell membrane, or changing the chromosomes in the nucleus. In animal experiments, it was found that 30 μg/m ozone injection into the intervertebral disc significantly dehydrated the nucleus pulposus after 1 month and dried up and necrosed the nucleus pulposus cells after 2 months. The destruction of nucleus pulposus cells further reduced the synthesis and secretion of proteoglycans. 2, chemical mechanism Prominent nucleus pulposus release inflammatory chemical mediators, nerve growth into the inner layer of the fibrous ring, can lead to autoimmune inflammatory reaction; at the same time, the protruding nucleus pulposus compress the epidural and nerve roots around the blood vessels, so that venous reflux is blocked, venous stasis, exudation and tissue edema. Experimental studies have shown that ozone is anti-inflammatory through the following mechanisms: (1) inducing the overexpression of antioxidant enzymes, eliminating the excess ROS produced in the inflammatory response and other pathophysiological processes; (2) stimulating the production of cytokines that antagonize the inflammatory response, such as IL-10, TGF-β1; inhibiting the expression of inflammatory factors such as IL-1, IL-2, IL-6, TNFα, etc. (3) Stimulate the release of NO and PDGF from vascular endothelial cells to promote vasodilation in the lesion area, increase oxygen supply, and promote inflammation absorption. As a result, local microcirculation is improved, venous stasis is released, oxygenation is improved, oxygen supply is increased, and nerve root ischemic edema is reduced. 3.Analgesic mechanism Ozone can inhibit unmyelinated injury receptor fibers, activate the anti-injury system, stimulate inhibitory interneurons, release enkephalins, and exert analgesic effects. Animal research found that ozone subcutaneous injection can reduce the neuropathic pain behavior of the injured sciatic nerve in rats, and research shows that ozone can regulate gene expression and play an important role in the development of touch-induced pain (allodynia). In 1998, Muto et al. first reported the medical ozone treatment for lumbar disc herniation, and then the technology was widely carried out in Europe, Brazil, India and other countries. In China, this treatment technology has been introduced since 2000, and a lot of clinical experience has been accumulated in China for more than 10 years. At present, medical ozone treatment for lumbar disc herniation has become a new minimally invasive interventional treatment method, which is less invasive, more direct and rapid in drug delivery, more satisfactory in efficiency, can reduce or avoid postoperative complications, and has incomparable advantages of other percutaneous minimally invasive disc treatment techniques. Adverse reactions in ozone therapy for lumbar disc herniation: The incidence of adverse reactions in ozone therapy for lumbar disc herniation is extremely low, generally less than 0.1%, with no or very few adverse reactions occurring at therapeutic concentrations of 10~40μg/ml, with only a few cases reported. There are reports of temporary sensory abnormalities during ozone injection, which can recover on their own. This may be due to a sudden, transient pressure spike in the spinal canal or cerebrospinal fluid after ozone injection into the intervertebral disc, which may cause transient nerve root injury through the transmission mechanism of pressure in the cerebrospinal fluid. Medical ozone has unique advantages in the treatment of lumbar disc herniation. We should select the appropriate indications, choose the appropriate treatment dose and treatment plan, emphasize individualized and comprehensive treatment, and strictly follow the operating procedures and strict aseptic operation during the operation in order to achieve the best treatment effect and avoid adverse reactions.