- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02525120
Post Market Non-Inferiority Study Comparing Triojection® to Discectomy for Lumbar Disc Herniation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The objective of this study is to compare clinical, economic and safety outcomes between Triojection and surgical discectomy. The study will include two follow-up phases: 1) an initial follow-up period during the first 6 months after treatment and (2) a long-term follow-up lasting an additional 18 months (2 years total).
The hypothesis is that over the first six months after treatment, Triojection® will be non-inferior to discectomy with respect to the improvement in leg pain. This will be demonstrated using a non-inferiority margin of 19.4 points on the difference between baseline leg pain score and the average leg pain score recorded at 1 week, 1, 3 and 6 months.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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Haidari
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Athens, Haidari, Greece, 12462
- University General Hospital Attikon
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Lombardia
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Bergamo, Lombardia, Italy, 24127
- Azienda Ospedaliera Papa Giovanni XXIII
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Lugano, Switzerland, 6900
- Ospedale Regionale di Lugano- Civico e Italiano
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
- Patient is willing to provide informed consent.
- Clinical and radiographic evidence of one, and only one, symptomatic protruding or extruded disc between L1 and S1.
- The herniated disc should have a disc height of at least 50% that of the normal adjacent disc levels, as determined by the investigator.
- The signal intensity of the herniated disc material should be equal or greater than the nucleus pulposus of the herniated disc.
- The patient must have pain in a dermatomal distribution consistent with their radiographic findings
- Leg pain greater than or equal to 5 on the NRS scale
- Symptoms for at least 6 weeks
- Willingness to complete all follow-up evaluations
- Patient aged 18-65 years
- BMI<40
Exclusion Criteria:
- Patients with a disc herniation extending past the facet joint
- Presence of a non-contiguous disc fragment
- Impairment of bladder/bowel function or motor impairment in the affected leg
- An epidural steroid injection in the past 2 weeks
- Previous discectomy, arthroplasty or fusion at any lumbar level
- In patients with L5-S1 disc herniation, a congenital condition where the L5 vertebral body is either fused to the sacrum or the L5-S1 disc is not fully formed as a normal adult disc.
- Symptomatic lumbar stenosis or listhesis
- Symptomatic sacroiliac joint
- Symptomatic foraminal stenosis due to severe degenerative disc disease
- History of spinal tumor, fracture or infection
- Females of childbearing age that are known to be pregnant or wishing to become pregnant during the study
- Fibromyalgia
- Active infection
- Metastatic cancer within the past 5 years
- Pending litigation against a health care provider
- More than 3 months of continuous sick leave prior to enrollment.
- Known drug or alcohol abuse
- Diagnosed psychiatric disease or psychological distress caused by recent trauma like divorce, death of a member family or loss of a job
- Patient known to be affected by favism (G6PD deficiency)
Study Plan
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 |
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Experimental: Triojection System for ozone injection
Triojection is a system including a single-use sterile syringe cartridge and an accessory console.
The console is interfaced to a supply of medical oxygen and uses this supply to fill the syringe with oxygen.
Ozone is produced by applying a high voltage to electrodes physically located within the syringe.
When a concentration of 35µg/ml is reached, the cartridge is removed from the console.
The sterile syringe, containing the gas, is extracted from the protective housing and the gas is administered directly to the center of the herniated disc through a spinal needle.
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Triojection is system intended to deliver a specific amount of ozone to a herniated disc.
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Active Comparator: Surgical discectomy
The surgical group will be receive a standard surgical discectomy to remove the herniated disc material.
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Patients will receive surgery to remove the herniated disc material.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Leg pain NRS
Time Frame: Baseline, 1 week, 1, 3 and 6 months.
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The primary outcome measure will be the amount of improvement in leg pain after treatment.
This will be determined by taking the difference between the baseline score and the average of the post-treatment scores at 1 week, 1, 3 and 6 months.
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Baseline, 1 week, 1, 3 and 6 months.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Leg pain NRS
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Leg pain Numerical Rating Scale (NRS) at each visit.
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Back pain NRS
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Back pain Numerical Rating Scale (NRS) at each visit
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Functional Score measured by RMDI.
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Roland Morris Disability Index.
A 24 question survey asking the subject if they have difficulty with various activities of daily living.
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Quality of Life measured by EQ-5D
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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EQ-5D is a validated survey asking the subject 5 multiple choice questions and to indicate their general health status on a scale of 0-100.
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Patient Satisfaction via a survey
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Brief questionnaire asking patients to rate their level of satisfaction.
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Cost Diary
Time Frame: Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Survey asking patients to detail their medical expenses, work status, time off work etc.
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Baseline and 1 week, 1, 3, 6, 12, 18 and 24 months after treatment.
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Review of MRI images
Time Frame: Baseline and 6 and 24 months after treatment.
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Blinded, independent MRI review to determine reduction in disc herniation following treatment and evaluate index and adjacent levels for evidence of degeneration.
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Baseline and 6 and 24 months after treatment.
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adverse Events
Time Frame: Through 24 months
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All adverse events are to be reported, per ISO 14155.
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Through 24 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Josip Buric, MD, Centro Chirurgico San Paolo, Pistoia, Italy
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1CP-1
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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