- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07688915
High-Intensity Laser Therapy Versus Transforaminal Epidural Steroid Injection in Chronic Lumbar Disc Herniation-Related Low Back and Radicular Pain
Comparison of the Effectiveness of High-Intensity Laser Therapy and Transforaminal Epidural Steroid Injection in Patients With Chronic Axial and Radicular Low Back Pain Due to Lumbar Disc Herniation: A Prospective Randomized Controlled Trial
Přehled studie
Postavení
Podmínky
Detailní popis
Low back pain is one of the most common musculoskeletal complaints and may lead to substantial disability and reduced quality of life. Lumbar disc herniation is a frequent cause of chronic axial and radicular low back pain.
High-intensity laser therapy is a non-invasive physical therapy modality with analgesic, anti-inflammatory, and biostimulatory effects. Transforaminal epidural steroid injection is a minimally invasive interventional treatment commonly used for radicular pain associated with lumbar disc herniation.
This prospective randomized controlled trial will include adult patients aged 18 to 65 years with chronic axial and radicular low back pain due to lumbar disc herniation. Participants will be randomized into two parallel groups. One group will receive high-intensity laser therapy for 15 sessions over 3 weeks, and the other group will receive fluoroscopy-guided transforaminal epidural steroid injection. All participants will receive a standardized home-based exercise program. Outcomes will be assessed at baseline, 2 weeks, 6 weeks, and 12 weeks after treatment.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Esra Ülgen Kıratlıoğlu, MD
- Telefonní číslo: +905079614194
- E-mail: esraulgen@gmail.com
Studijní místa
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Ankara, Turecko (Türkiye)
- Nábor
- Ankara Bilkent City Hospital, Physical Medicine and Rehabilitation Hospital
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Kontakt:
- Esra Ülgen Kıratlıoğlu
- Telefonní číslo: +905079614194
- E-mail: esraulgen@gmail.com
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Age between 18 and 65 years
- Diagnosis of lumbar disc herniation confirmed by clinical examination and lumbar magnetic resonance imaging
- Chronic axial low back pain and radicular pain related to lumbar disc herniation
- Low back and/or radicular pain lasting longer than 3 months
- Resting low back and/or radicular pain intensity of ≥5 on a 0-10 visual analog scale
- Willingness to participate in the study and provide written informed consent
Exclusion Criteria:
- Pregnancy or suspected pregnancy
- Presence of a cardiac pacemaker
- History of epilepsy
- Active or previous malignancy
- History of spinal surgery
- Uncontrolled systemic or psychiatric disease
- Cauda equina syndrome or progressive neurological deficit
- Peripheral neuropathy, including diabetic or alcohol-related neuropathy
- Neurodegenerative disease
- Acute trauma
- Active systemic infection
- Local infection or skin disease at the injection site or treatment area
- Body mass index greater than 40 kg/m²
- Bleeding disorder that contraindicates treatment
- Spinal stenosis, spondylolysis, or spondylolisthesis
- Neurogenic bladder or bowel syndrome
- Rheumatologic disease
- Arterial vascular disease or vascular claudication
- Receipt of other physical therapy modalities within the last 3 months
- Receipt of spinal injection therapy within the last 3 months
- History of allergy to injection agents
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Experimentální: High-Intensity Laser Therapy
Participants in this group will receive high-intensity laser therapy using a pulsed Nd:YAG laser device for 15 sessions over 3 weeks.
Treatment will be applied to the lumbar paravertebral region using the lumbosciatalgia mode.
All participants will also receive a home exercise program.
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High-intensity laser therapy will be applied using a pulsed Nd:YAG laser with a wavelength of 1064 nm.
Treatment will be delivered in 15 sessions over 3 weeks to the lumbar paravertebral region.
Each session will last approximately 10-12 minutes with a total energy dose of 2500 joules.
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Aktivní komparátor: Transforaminal Epidural Steroid Injection
Participants in this group will receive fluoroscopy-guided transforaminal epidural steroid injection.
The injection level will be determined according to physical examination and lumbar magnetic resonance imaging findings.
All participants will also receive a home exercise program.
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Fluoroscopy-guided transforaminal epidural steroid injection will be performed by an experienced physical medicine and rehabilitation specialist.
After confirmation of needle placement with contrast medium, 2 mL of 2% lidocaine hydrochloride and 8 mg/2 mL dexamethasone will be administered.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in Low Back and Leg Pain Intensity Assessed by Visual Analog Scale
Časové okno: Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Pain intensity at rest will be assessed using the visual analog scale.
Participants will be asked to indicate their current low back and radicular leg pain intensity on a 10-cm horizontal line, where 0 indicates no pain and 10 indicates the worst pain imaginable.
Higher scores indicate greater pain intensity.
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Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in Disability Assessed by the Oswestry Disability Index
Časové okno: Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Disability related to low back pain will be assessed using the Oswestry Disability Index.
The questionnaire includes 10 sections evaluating pain intensity and the effect of pain on daily activities.
The total score is converted to a percentage from 0 to 100, with higher scores indicating greater disability.
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Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Change in Neuropathic Pain Assessed by the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale
Časové okno: Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Neuropathic pain features will be assessed using the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale.
The scale consists of symptom-based and examination-based items.
A total score of 12 or higher suggests neuropathic pain, while a score below 12 suggests nociceptive pain.
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Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Change in Health-Related Quality of Life Assessed by the Short Form-36 Health Survey
Časové okno: Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Health-related quality of life will be assessed using the Short Form-36 Health Survey.
The questionnaire includes eight domains: physical functioning, role limitations due to physical health, role limitations due to emotional problems, vitality, mental health, social functioning, bodily pain, and general health perception.
Each domain is scored from 0 to 100, with higher scores indicating better health status.
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Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Change in Functional Walking Capacity Assessed by the Six-Minute Walk Test
Časové okno: Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Functional walking capacity will be assessed using the Six-Minute Walk Test.
Participants will be instructed to walk as far as possible along a flat walking area for 6 minutes.
The total distance walked in meters will be recorded, with longer distances indicating better functional walking capacity.
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Baseline, 2 weeks, 6 weeks, and 12 weeks after treatment
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Spolupracovníci a vyšetřovatelé
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- TABED 1-25-1769
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