- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02358291
Microendoscopic Discectomy Vs Transforaminal Endoscopic Lumbar Discectomy Vs Open Discectomy
February 6, 2015 updated by: Kun Wang, Southeast University, China
Microendoscopic Discectomy Vs Transforaminal Endoscopic Lumbar Discectomy Vs Open Discectomy for the Treatment of Lumbar Disc Herniation
In our study, a multicenter randomized controlled,single blind trial will be performed to evaluate the effectiveness and safety of these three procedures for the treatment of symptomatic lumbar disc herniation.
Study Overview
Status
Unknown
Conditions
Detailed Description
Lumbar disc herniation (LDH) is one of the most common diseases in the department of orthopedics, which produced medical and economic burdens to families and society.
In spite, the majority of the patients with disc herniation can be relieved or even cured via conservative treatment; there are still a considerable number of invalid patients who eventually still need to be undergoing a surgical operation treatment.
Three main methods for intervertebral disc surgery are adopted in our routine work.
One procedure is Open Discectomy (OD), which has been always a gold standard for treatment of LDH.
And the other two procedures are Microendoscopic Discectomy (MED) and Transforaminal Endoscopic Lumbar Discectomy (TELD) respectively.
MED and TELD have been developed as alternatives to OD. OD can compress the nerve root or spinal cord through removal of the protrusion.
However, it destroys the rear structure of spine, causing segmental instability and long-term distress.
Compared with OD, MED and TELD procedures are smaller incisions or less dissection (or both), lower blood loss, less postoperative pain, shorter hospitalisation and earlier return to work.
However, the steep learning curves of MID inhibit the development of surgery specialists; for example, optimal surgical management requires many years of experience.
These deficiencies need more educational effort at a higher priority than accorded so far.
There are inconsistent outcomes about the efficacy and safety in the previous studies; all of the recent researches do not yield conclusive results.
Study Type
Interventional
Enrollment (Anticipated)
240
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Wang Kun, PHD
- Phone Number: +86(25)-83262331
- Email: wangkunspine@163.com
Study Contact Backup
- Name: Wu Xiaotao, MD
- Phone Number: +86(25)-83262331
- Email: wuxiaotao@medmail.com.cn
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- All forms of disc herniation were included in the study
- History of concordant radicular leg pain refractory to conservative treatment for longer than 6 months
- Leg pain must be greater than back pain
Exclusion Criteria:
- cauda equine syndrome,
- progressive neurologic deficit,
- bilateral lower extremity symptoms,
- low back pain more than leg pain
- Systemic infection or localized infection at the anticipated entry needle site
- combined with lumbar infection, fracture of lumbar vertebra, tumor, Ⅱ°and above spondylolisthesis, lumbar spinal stenosis, lumbar scoliosis is larger than 15 degree
- with severe heart, brain, lungs, and other organs disease or mental illness
- History of opioid abuse or patients currently on long acting opioid
- History of the operation on lumbar
- Pregnancy
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: open discectomy
patients diagnosed as lumbar disc herniation undergoing open simple discectomy(OD)
|
Microendoscopic discectomy combines standard lumbar microsurgical techniques with endoscope, enabling surgeons to successfully address free-fragment disc pathologic factors and lateral recess stenosis.
transforaminal endoscopic lumbar discectomy removes the intervertebral disc portion through the intervertebral foramen
|
Active Comparator: microendoscopic discectomy
patients diagnosed as lumbar disc herniation undergoing microendoscopic discectomy(MED)
|
transforaminal endoscopic lumbar discectomy removes the intervertebral disc portion through the intervertebral foramen
The open discectomy, will be performed under general anesthesia in the prone position with horizontal.
The level of the spine indicated for surgical treatment will be identified with the aid of fluoroscopy.
An incision is made about the dorsal disc level involved with dissection of the paravertebral muscles on the side of disc herniation.
After laminectomy and resection of part of the yellow ligament, partial discectomy is done under direct vision.
|
Active Comparator: transforaminal endoscopic discectomy
patients diagnosed as lumbar disc herniation undergoing transforaminal endoscopic lumbar discectomy(TELD)
|
Microendoscopic discectomy combines standard lumbar microsurgical techniques with endoscope, enabling surgeons to successfully address free-fragment disc pathologic factors and lateral recess stenosis.
The open discectomy, will be performed under general anesthesia in the prone position with horizontal.
The level of the spine indicated for surgical treatment will be identified with the aid of fluoroscopy.
An incision is made about the dorsal disc level involved with dissection of the paravertebral muscles on the side of disc herniation.
After laminectomy and resection of part of the yellow ligament, partial discectomy is done under direct vision.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oswestry Disability Index(ODI)
Time Frame: up to 104 weeks
|
Oswestry Disability Index (ODI) -> The Oswestry Disability Index (ODI) is one of the principal condition-specific outcome measures used in the management of spinal disorders.
The ODI is the most commonly outcome measures in patients with low back pain.
Each of the 10 items is scored from 0 - 5. The maximum score is therefore 50.
If the FIRST statement is marked, the section score = 0, If the LAST statement is marked, it = 5. 0 is the best outcome and 50 is the worst The ODI is the most commonly outcome measures in patients with low back pain.
Each of the 10 items is scored from 0 - 5. The maximum score is therefore 50.
If the FIRST statement is marked, the section score = 0, If the LAST statement is marked, it = 5. 0 is the best outcome and 50 is the worst outcome
|
up to 104 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
visual analogue scale(VAS)
Time Frame: up to 104 weeks
|
Pain Score - Visual Analog Scale (VAS) -> minimum value=0 and maximum value=10, higher values represent a worse outcome and zero is a better outcome
|
up to 104 weeks
|
The generic health survey on the Short Form-36(SF-36)
Time Frame: up to 104 weeks
|
The scale was used to evaluate the quality of life
|
up to 104 weeks
|
Complications survey
Time Frame: up to 104 weeks
|
Complications of surgery including mortality and common: thrombosis; surgical site and other infections; recurrent disc herniation; dural tear; nerve root injury
|
up to 104 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Wu Xiaotao, MD, Zhangda hospital,Southeast university
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Liu WG, Wu XT, Guo JH, Zhuang SY, Teng GJ. Long-term outcomes of patients with lumbar disc herniation treated with percutaneous discectomy: comparative study with microendoscopic discectomy. Cardiovasc Intervent Radiol. 2010 Aug;33(4):780-6. doi: 10.1007/s00270-009-9720-6. Epub 2009 Oct 15.
- Wu X, Zhuang S, Mao Z, Chen H. Microendoscopic discectomy for lumbar disc herniation: surgical technique and outcome in 873 consecutive cases. Spine (Phila Pa 1976). 2006 Nov 1;31(23):2689-94. doi: 10.1097/01.brs.0000244615.43199.07.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
March 1, 2015
Primary Completion (Anticipated)
March 1, 2017
Study Completion (Anticipated)
March 1, 2017
Study Registration Dates
First Submitted
January 26, 2015
First Submitted That Met QC Criteria
February 5, 2015
First Posted (Estimate)
February 6, 2015
Study Record Updates
Last Update Posted (Estimate)
February 9, 2015
Last Update Submitted That Met QC Criteria
February 6, 2015
Last Verified
February 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- WANG-8808-KUN
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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