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Percutaneous Intradiscal Radiofrequency as A Treatment for Radicular Pain From Lumbar Disc Herniation

Not Applicable
Recruiting
Conditions
Radicular Pain
Disk Herniated Lumbar
Intradiscal Radiofrequency
Interventions
Device: Percutaneous intradiscal radiofrequency treatment
Registration Number
NCT05747807
Lead Sponsor
Chulalongkorn University
Brief Summary

The goal of this clinical trial is to demonstrate the efficacy of percutaneous intradiscal radiofrequency as a treatment for radicular pain from lumbar disc herniation.

The main question it aims to answer is:

• Can percutaneous intradiscal radiofrequency lower the severity of radicular pain from lumbar disc herniation Participants will be treated with percutaneous intradiscal radiofrequency and evaluated for radicular pain severity before and 3 months after the procedure.

There is no comparison group.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
18
Inclusion Criteria
  1. 18-85 year-old patients with radicular pain from lumbar disc herniation for ≥ 3 months
  2. Lumbar disc herniation ≤ 2 locations evidenced by MRI, with ≥ 50% remaining disc height, without disc sequestration
  3. Previously treated with epidural steroid injection (ESI) and achieved ≥ 50 % pain relief from local anesthetic effect, confirming radicular pain from lumbar disc herniation, but did not respond to ESI (< 50 % Pain relief or pain relief < 3 months)
Exclusion Criteria
  • Patient refusal
  • Discitis
  • Previous lumbar spine surgery
  • Progressive neurological deficit and/or cauda equina syndrome
  • Coagulopathy
  • Allergic to any medication in study protocols
  • Unable to rate the pain
  • Pain in any area worse than the radicular pain

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Percutaneous intradiscal radiofrequencyPercutaneous intradiscal radiofrequency treatmentStandard monitoring ,prone position, sterile prepped and draped No sedation, Fentanyl 0.5-2 mcg/kg IV as needed ATB prophylaxis: ceftriaxone 1 g IV Performed by interventional pain physician, under fluoroscopic guidance 2% lidocaine 5 ml LA using Flextrode introducer kit, Boston Scientific Corporation Using an extrapedicular approach ipsilateral to the prolapse, the Flextrode cannula is advanced to the posterior disc. The Flextrode electrode is inserted through the cannula. Sensory (50Hz) and motor (2Hz) stimulation, 3 Volts amplitude and 1msec pulse width. Confirm no sensory/motor response. Lateral, AP, and oblique x-ray views are used to confirm the active tips are fully within the disc Thermal RF: temp 80 ◦C, 4 min Ceftriaxone 75 mg intradiscal injection via the cannula
Primary Outcome Measures
NameTimeMethod
Change from baseline radicular pain score at 2 weekspre-treatment and 2 week post-treatment

Radicular pain severity using numerical rating scale (0-10) Zero represents 'no pain at all' whereas 10 represents 'the worst pain ever possible'.

Change from baseline radicular pain score at 3 monthspre-treatment and 3 months post-treatment

Radicular pain severity using numerical rating scale (0-10) Zero represents 'no pain at all' whereas 10 represents 'the worst pain ever possible'.

Secondary Outcome Measures
NameTimeMethod
Oswestry Disability Index (ODI) at 3 months3 month post-treatment

using Oswestry questionnaire version 1.0 - Thai version

The ODI is comprised of 10 questions that ask patients about their ability to manage everyday life, and covers intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel. Each question contains 6 statements that correlate to a score of 0 through 5, where the patient is to choose the statement that best matches their ability. To obtain the index, the scores of all questions are summed and then multiplied by two.

The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound.

using Oswestry questionnaire version 1.0 - Thai version

WHOQOL-Brief total score at baselinepre-treatment

using WHOQOL-Brief-Thai questionnaire

The WHO Quality of Life-BREF (WHOQOL-BREF) is a 26-item questionnaire that measures an individual's quality of life.

The final score ranges from 0-100. 0 points represent the worst possible state of health, while 100 points represent the best possible state of health.

WHOQOL-Brief total score at 2 weeks2 week post-treatment

using WHOQOL-Brief-Thai questionnaire

The WHO Quality of Life-BREF (WHOQOL-BREF) is a 26-item questionnaire that measures an individual's quality of life.

The final score ranges from 0-100. 0 points represent the worst possible state of health, while 100 points represent the best possible state of health.

WHOQOL-Brief total score at 3 months3 month post-treatment

using WHOQOL-Brief-Thai questionnaire

The WHO Quality of Life-BREF (WHOQOL-BREF) is a 26-item questionnaire that measures an individual's quality of life.

The final score ranges from 0-100. 0 points represent the worst possible state of health, while 100 points represent the best possible state of health.

Oswestry Disability Index (ODI) at baselinepre-treatment

using Oswestry questionnaire version 1.0 - Thai version

The ODI is comprised of 10 questions that ask patients about their ability to manage everyday life, and covers intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel. Each question contains 6 statements that correlate to a score of 0 through 5, where the patient is to choose the statement that best matches their ability. To obtain the index, the scores of all questions are summed and then multiplied by two.

The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound.

Oswestry Disability Index (ODI) at 2 weeks2 week post-treatment

using Oswestry questionnaire version 1.0 - Thai version

The ODI is comprised of 10 questions that ask patients about their ability to manage everyday life, and covers intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel. Each question contains 6 statements that correlate to a score of 0 through 5, where the patient is to choose the statement that best matches their ability. To obtain the index, the scores of all questions are summed and then multiplied by two.

The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound.

using Oswestry questionnaire version 1.0 - Thai version

Trial Locations

Locations (1)

King Chulalongkorn Memorial Hospital

🇹🇭

Bangkok, Thailand

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