- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00300898
Radiofrequency Nucleoplasty vs Percutaneous Nucleotomy vs Decompression Catheter in Lumbar Disc Herniation
Radiofrequency Nucleoplasty vs Percutaneous Nucleotomy (Dekompressor) vs Decompression Catheter for the Treatment of Painful Contained Lumbar Disc Herniation: A Prospective Randomized Controlled Study
Study Overview
Status
Conditions
Detailed Description
Contained herniation of the lumbar intervertebral disc is a frequent cause of leg and back pain. Over the last decade, there is a tendency to shift from surgical treatment of the intervertebral disc including laminectomy/discectomy to an excess of nonoperative management. Three techniques introduced recently are used as minimally invasive treatments for decompression of contained herniation of the nucleus pulposus. Nucleoplasty uses Coblation® radiofrequency vaporization of nuclear tissue to decompress the intervertebral disc. Catheter disc decompression uses heat from a resistive coil positioned in the area of disc herniation while Dekompressor® uses volume reduction to decrease an intradiscal pressure.
This is a comparison study which investigates if intervertebral electrothermal disc decompression produces better pain relief measured on VAS scale, improvement in functional capacity, return to work and opioid use, than nucleoplasty or percutaneous disc decompression (Dekompressor) of the lumbar intervertebral disc in a prospective randomized controlled study. Patients will be randomized into four treatment groups in equal numbers. The first group will be treated using nucleoplasty, the second will receive Dekompressor® lumbar disc decompression, the third will receive thermal treatment using decompression catheter (Achutherm TM) and the forth will be the control group. The control group will be treated conservatively using medications including gabapentin, a breakthrough opioid (oxycodone 5 mg 1-2 tablets q 4-6 hours as needed), NSAID, epidural steroid injections and physical therapy.
Patients will be followed and assessed at one, three, six, nine and twelve months following the procedure using VAS scores, Oswestry and SF-36 Short Form questionnaires, opioid use and return to work evaluation.
Study Type
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- History of concordant radicular leg pain unresponsive to conservative treatment for longer than 3 months
- Leg pain must be greater than back pain
- Contained disc herniation as evidenced by MRI
- No evidence of psychological issues by exam or history
Exclusion Criteria:
- A score of greater than 10 on Beck Depression Inventory (BDI)
- Patients with pending workers compensation claim or litigation
- Pregnancy
- Tumor
- Systemic infection or localized infection at the anticipated entry needle site
- Traumatic spinal fracture
- History of coagulopathy
- Unexplained bleeding
- Progressive neurological deficits
- History of opioid abuse or patients currently on long acting opioids
- Patients presenting with moderate or severe lumbar central or lateral canal stenosis, free disc fragments or degenerative disc disease as described on MRI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Nucleoplasty
Procedure/Surgery: Nucleoplasty
|
|
Active Comparator: Percutaneous decompression
Procedure/Surgery: Percutaneous decompression
|
|
Active Comparator: Electrothermal disc decompression (IDET)
Procedure/Surgery: Intervertebral electrothermal disc decompression (IDET)
|
|
Experimental: Behavioral:Conservative treatment
Conservative treatment with oral medications, physical therapy, epidural steroid injections
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
VAS pain evaluation score at baseline, 1, 3, 6, 9, 12 months
Time Frame: baseline 1, 3, 6, 9, 12 months
|
baseline 1, 3, 6, 9, 12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oswestry results
Time Frame: baseline 1, 3, 6, 9, 12 months
|
Disability Index
|
baseline 1, 3, 6, 9, 12 months
|
Quality of Life SF-36
Time Frame: baseline 1, 3, 6, 9, 12 months
|
SF-36 score at baseline 1, 3, 6, 9, 12 months
|
baseline 1, 3, 6, 9, 12 months
|
Return to work evaluation
Time Frame: 1 month
|
Return to work evaluation
|
1 month
|
Depression score
Time Frame: BASELINE
|
Beck Depression Inventory score at pre-treatment visit
|
BASELINE
|
Opioid use
Time Frame: 1, 3, 6, 9, 12 months
|
Opioid use
|
1, 3, 6, 9, 12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Leonardo Kapural, MD, OhD, Cleveland Clinic Foundation, Pain Management Department
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB 8006
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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