Discogène pour les lombalgies
Étude pilote de faisabilité en double aveugle du dispositif Discogen pour soulager les douleurs discogènes du dos et des jambes radiculaires
This study will be a double-blinded, two-arm, prospective, randomized controlled pilot feasibility study in 40 evaluable subjects (20 in each arm) at one study site within the United States. Subjects in Arm 1 will receive unilateral Discogen treatment; subjects in Arm 2 will receive unilateral sham treatment (control). Treatment in both arms can include medications, e.g. NSAIDs or muscle relaxants for axial or radicular pain.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This study will be a double-blinded, two-arm, prospective, randomized controlled pilot feasibility study in 40 evaluable subjects (20 in each arm) at one study site within the United States. Subjects in Arm 1 will receive unilateral Discogen treatment; subjects in Arm 2 will receive unilateral sham treatment (control). Treatment in both arms can include medications, e.g. NSAIDs or muscle relaxants for axial or radicular pain. This study will enroll 40 evaluable subjects and follow them for 60 days.
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Investigate the safety and feasibility of the Discogen device to alleviate back/radicular leg pain
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Assess the mean reduction in back and radicular leg pain following Discogen treatment.
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Primary Safety - collection of all adverse events, including any device- or procedure-related adverse events
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Primary Effectiveness -percent change from baseline for Numerical Pain Scale (NPS) radicular leg pain at 30 and 60 days. The scale ranges from 0(No pain) to 10 (Severe pain).
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Secondary Effectiveness:
- Change from baseline in Oswestry Disability Index at 30 and 60 days. The Index ranges from 0-20% (minimal disability), 21-40% (moderate disability), 41-60% (severe disability), 61-80% (crippled), to 81-100% (bed bound).
- Percent change from baseline NPS back pain at 30 and 60 days
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Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Michael Spinner, MS
- Numéro de téléphone: 212-305-9416
- E-mail: ms6431@cumc.columbia.edu
Sauvegarde des contacts de l'étude
- Nom: Clark Smith, MD, PhD
- Numéro de téléphone: 212-305-2134
- E-mail: cs3028@cumc.columbia.edu
Lieux d'étude
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New York
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New York, New York, États-Unis, 10032
- Recrutement
- Columbia University Irving Medical Center
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Contact:
- Michael Spinner
- Numéro de téléphone: 5164594518
- E-mail: ms6431@cumc.columbia.edu
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria
The subject may be included in the study if the following conditions are met:
- Adult (> 21 y.o.) males and females legally able and willing to participate and provide consent in the study and attend follow-up visits
- Able and willing to complete study forms and communicate with the investigator
- Presenting with unilateral radicular leg pain with or without axial back pain of >1 month duration
- No epidural injections at treatment site within the last three months
- Leg NPS pain score of 4 - 9 in the last month (on a scale of 0 to 10)
- Clinical presentation of sensory radiculopathy referable to single-level disc disease/herniation at L3-4, L4-5 or L5-S1
- MRI lumbar spine negative for extruded disc herniation, tumor, or bleeding, but positive for disc disease/herniation at L3-4, L4-5 or L5-S1 with mild to moderate foraminal or spinal stenosis (less than 50%).
Exclusion Criteria:
- Pregnant or breastfeeding patient
- Younger than 21 or older than 75 years
- Presenting with motor deficits
- Presenting with a baseline Oswestry Disability Index ≥ 41% (severe disability or worse)
- Presence of metal hardware within the lumbosacral spine
- History of spine surgery at the level of treatment.
- Lumbar spine pathology that may increase procedural risk and/or influence symptoms and/or generate unrelated adverse events (per the discretion of the study PI)
- Severe lumbar central canal stenosis (greater than 50%)
- Severe lumbar foraminal stenosis (greater than 50%)
- Severe herniated lumbar disc 4(Grade 2 and above)
- Lumbar instability on flexion/extension plain films, greater the Grade 1 spondylolisthesis
- Unable to understand and complete research questionnaires
- Any severe medical condition preventing the patient from safely and effectively being treated in the study or reporting study outcomes.
- BMI greater than 30
- Implanted spinal stimulators
- Epidural injections at treatment site within the last three months
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Treatment Group
Study subjects in the treatment group (Arm 1) will receive 3 daily Discogen treatments unilaterally within a one week (M-M) period, each lasting 25 minutes. |
The device is a customized Low Intensity Pulsed Ultrasound (LIPUS) transducer system and power source. The transducer is biocompatible for skin contact. The system is capable of calibration to desired treatment parameters. The study subject will be placed in the prone position with all appropriate pressure points padded on the exam table. For the first treatment, fluoroscopic imaging (and/or ultrasonic guidance) will be used to guide the placement of the transducer over the anatomic target, unilateral at the L3-4, L4-5 or L5-S1 levels. The skin of the study subject's back will be marked with non-washable marking pen to indicate the site for placing the transducer during the first treatment. The subsequent treatment (second and third) can be done without using ultrasound guidance. The transducer will be placed on the marked site during the second and third treatment. The ultrasound signal will be delivered unilaterally for 25 minutes, using a timer visible to the patient. The power ge |
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Comparateur factice: Sham Control Group
Subjects in the sham control arm (Arm 2) will receive 3 daily non-powered treatments unilaterally within a one week (M-M) period, each lasting 25 minutes |
The ultrasound signal will be delivered unilaterally for 25 minutes, using a timer visible to the patient. The power generator will not be turned on for the sham treatment, but the wave generator will be displayed. All study subjects will receive a total of three daily Discogen treatments over the span of a single M-M work week |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Primary Effectiveness
Délai: 30 and 60 days.
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Percent change from baseline for Numerical Pain Scale (NPS) radicular leg pain at 30 and 60 days. The NPS is a patient-reported assessment of pain intensity, ranging from 0 (No pain) to 10 (Severe pain). |
30 and 60 days.
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Primary Safety
Délai: 60 days
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Collection of all adverse events, including any device or procedure-related adverse events. |
60 days
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline in Oswestry Disability Index
Délai: 30 and 60 days.
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The Oswestry Disability Index is a patient-reported assessment of level of function (disability) in those living with low back pain. The Index ranges from 0-20% (minimal disability), 21-40% (moderate disability), 41-60% (severe disability), 61-80% (crippled), to 81-100% (bed bound). |
30 and 60 days.
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Numerical Pain Scale (NPS)
Délai: 30 and 60 days.
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Percent change from baseline NPS back pain. The scale ranges from 0 (No pain) to 10 (Severe pain). |
30 and 60 days.
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Clark Smith, MD, PhD, Columbia University
Publications et liens utiles
Publications générales
- Su ZH, Liu J, Yang MS, Chen ZY, You K, Shen J, Huang CJ, Zhao QH, Liu EQ, Zhao L, Feng QJ, Pang SM, Li SL, Lu H. Automatic Grading of Disc Herniation, Central Canal Stenosis and Nerve Roots Compression in Lumbar Magnetic Resonance Image Diagnosis. Front Endocrinol (Lausanne). 2022 Jun 6;13:890371. doi: 10.3389/fendo.2022.890371. eCollection 2022.
- PASS 2021 Power Analysis and Sample Size Software (2021). NCSS, LLC. Kaysville, Utah, USA, ncss.com/software/pass.
- Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, Ranieri M, Di Teo L, Santamato A. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2011 Sep;47(3):367-73. Epub 2011 Jun 8.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- AAAU8219
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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