Nucleoplasty for Contained Herniated Lumbar Discs: A Randomised, Double Blind, Prospective Comparison With Sham Treatment
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Decrease in Jensen visual analogue scale (VAS)-score for pain
研究概览
简要总结
This is a prospective randomised double blind comparison trial. Fifty patients will be included, 25 in the nucleoplasty treatment group, 25 in the control group. The nucleoplasty group will undergo the nucleoplasty treatment. Control group will undergo a sham treatment. Both groups will undergo a standardised post-operative care program. The study hypothesis is that nucleoplasty will lead to earlier pain reduction as compared with the sham treatment.
详细描述
This study will include patients with a contained lumbar hernia of at least 6 weeks existence in whom leg pain is the predominant complaint. Standard treatment for these patients is conservative, as an operation is not without risks and is not always effective. Furthermore, complaints will usually resolve in due time. However, the pain limits the patients in their daily activities, often for a prolonged period.
In this study, nucleoplasty will be compared with a sham treatment and not with conservative treatment, as the discography is thought to have some therapeutic effect.
The primary outcome will be the proportion of patients with at least a 2.5 points decrease on a ten-point Jensen VAS score 3 months after treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Mono radicular leg pain for at least 6 weeks as a result from a lumbar contained herniated disc. Leg pain must be of greater impact than concomitant back-pain
- •Failing conservative treatment; analgesics and/or physical therapy. Failing means persisting pain leading to problems with daily activities.
- •Magnetic resonance imaging (MRI): must be performed < 6 weeks before start treatment. On MRI signs of contained herniated disc, maximum 33% obliteration of the spinal channel. No signs of other significant spine pathology (see
排除标准
- •Neurological investigation by neurologist. Symptoms should be clinically related to the disc herniation level.
- •Age >18 and < 60 years
- •Mean leg pain on visual analogue scale (VAS) >50 mm (0 -100)
- •Exclusion Criteria:
- •Herniated disc with more than 33% obliteration of the spinal channel.
- •Annulus rupture with sequestrated herniated disc.
- •Pain on VAS below 50 mm
- •Pain existing longer than one year
- •Less than 50% preserved disc height
- •Conflict with social security/insurance.
- •Major motor impairment as a result of the herniation, paresis grade 3 or more using a Medical Research Council (MRC) score
- •Other degenerative causes of nerve root compression; ligament flavum or facet joint hypertrophy, degenerative spinal channel stenosis, loss of lumbar kyphosis, discopathy with signs of Schmorls' nodules and loss of nucleus pulposus signal. Other causes of radicular syndrome such as cancer, radiculitis or neural degeneration.
- •Spinal instability (spondylolisthesis, spinal fracture or tumor)
- •History of back surgery, chemonucleolysis or other intra discal procedures
- •Coagulopathies or oral anti-coagulation therapy
- •Infection
- •Pregnancy
结局指标
主要结局
Decrease in Jensen visual analogue scale (VAS)-score for pain
次要结局
- McGill Pain Questionnaire-Dutch Language Version (MPQ-DLV)
- Quebec Back Pain Disability Scale
- Rand-36
- EuroQoL (European Quality of Life Scale)
- Costs (societal perspective)
- Multidimensional Pain Inventory (MPI-DLV)