- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00706459
Advanced MR Imaging in Patients With Painful, Degenerative Disc Disease: A Pilot Study
In this study, we will use advanced and newly available MR imaging techniques at 3 Tesla (including in situ axial loading and quantitative T1rho, T2, and diffusion measurements) to assess the intervertebral discs and adjacent vertebrae in patients with lumbar back pain scheduled for back surgery (n=20), patients with degenerative disease without classic discogenic back pain (n=10), patients who had discectomies for herniated discs (n=5), and age-matched volunteers without back pain (n=10). In all patients standard imaging procedures will also be performed, including radiographs, standard MRI at 1.5 Tesla and discography. All patients will have specimen of the intervertebral disc harvested at surgery and pathologic analysis and spectroscopy of these specimen will be performed. Post-surgical findings/outcome combined with discography will serve as a standard of reference for the identification of the painful disc(s). The diagnostic performance of the new techniques in assessing the painful disc will be evaluated. We will collect disc specimens from 50 patients undergoing back surgery but did not have pre-surgical MR imaging. These disc specimens will be analyzed in the same manner as the specimens collected from surgical patients who had pre-surgical MRI. This study will serve as a pilot study for a larger project focusing on advanced imaging of the painful intervertebral disc.
We hypothesis that advanced, dedicated MR examinations at 3T can identify painful degenerated discs in patients with chronic lumbar back pain.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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California
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San Francisco, California, United States, 94133
- University of California, San Francisco
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Potential subjects are patients seen by surgeons in the UCSF ACC Orthopedic Clinic. If a patient meets all inclusion and exclusion criteria, the orthopedic surgeon will talk to the patient about the new dedicated examinations using 3 Tesla MRI that can identify painful degenerated discs. When patient is comfortable with participating and has made a decision to go ahead with the MRI, patient can let the orthopedic surgeon's assistant know about his/her decision, the assistant will make sure that patient still meets the inclusion and exclusion criteria and will call the coordinator at the Imaging Center to set up an MRI appointment.
Flyers will be posted at different UCSF campuses to recruit for normal age-matched and young normal volunteers.
Description
Inclusion Criteria for Patient with classic discogenic back pain:
- age range 25-60 years old
- Back and/or leg (back>leg) pain
- Degenerative disc disease in one or more adjacent vertebral levels between L3-S1
- Radiologic confirmation of degenerative disc disease:
- Segmental instability (3 mm translation or 5 degree angulation)
- Decreased disc height >2 mm
- Scarring, thickening of annulus fibrosis
- Vacuum phenomenon
- No significant foraminal stenosis and nerve root compression
- Failed observative treatment for at least 6 months
- Oswestry LB disability questionnaire score of at least 20/50 (40%) (interpreted as moderate to severe disability)
- Psychosocially and mentally normal
- Patients who are scheduled for back surgery
Inclusion criteria for patients with degenerative disc disease without the classic discogenic back pain:
- Age range 25-60 years old
- Patients with diagnosis of idiopathic scoliosis, spondylolysis, or spondylolisthesis
Inclusion criteria for normal controls:
- No symptoms
- Age range 25-60 years old
Inclusion Criteria for post-surgical discectomy patients:
- Patients who had successful disc surgery for lumbar herniated disc and no further back pain
- Patients who had unsuccessful disc surgery for lumbar herniated disc and still with residual back pain
Exclusion Criteria:
- prior back surgery (except as mentioned above)
- spine fractures
- Radiographic confirmation of facet joint disease or degeneration
- Radiographic confirmation of sacroiliac joint pathology
- Lytic spondylolisthesis of spinal stenosis
- Degenerative spondylolisthesis of > grade 1
- Metabolic bone disease
- Spine infection , osteomyelitis
- Rheumatoid arthritis or any other systemic or autoimmune disease
- Active malignancy
- MRI Contraindications (fragment in eye, aneurysms clips, ear implants, spinal nerve stimulators, pacemaker, claustrophobia, or pregnant women, etc.,)
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
1
Patients with lumbar back pain scheduled for back surgery.
|
All study subjects will have a 3T MRI examination.
The MRI exam will take approximately 90 minutes to complete and will involve the scanning o the spine.
|
2
Patients with degenerative disease without classic discogenic back pain
|
All study subjects will have a 3T MRI examination.
The MRI exam will take approximately 90 minutes to complete and will involve the scanning o the spine.
|
3
Normal control without back pain.
|
All study subjects will have a 3T MRI examination.
The MRI exam will take approximately 90 minutes to complete and will involve the scanning o the spine.
|
4
Post Surgical discectomy patients
|
All study subjects will have a 3T MRI examination.
The MRI exam will take approximately 90 minutes to complete and will involve the scanning o the spine.
|
5
disc specimens
|
All study subjects will have a 3T MRI examination.
The MRI exam will take approximately 90 minutes to complete and will involve the scanning o the spine.
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Sharmila Majumdar, PhD, University of California, San Francisco
Study record dates
Study Major Dates
Study Start
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 (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SpineMRI
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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