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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04540068
Other study ID # POTEISS
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date November 15, 2020
Est. completion date December 2026

Study information

Verified date October 2023
Source Leiden University Medical Center
Contact Eduard JA Verheijen, Bsc.
Phone +3171526746
Email e.j.a.verheijen@lumc.nl
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Rationale: Treatment with transforaminal epidural injections is part of usual care in patients suffering from lumbar radiculopathy. However, not all patients experience a satisfactory result from this treatment and it is unclear what percentage of patients responds well and if any clinical or radiological factors exist that predict a positive response. Objectives: Primary: to develop a model based on demographic, clinical and radiological parameters for prediction of treatment success after TEI Secondary: to estimate the short-term efficacy of TEI in patients with LDH and spinal stenosis based on pain, functionality and perceived recovery scores, to determine the correlation between clinical and radiological baseline parameters and physical and psychological patient outcome measures, to determine the rate of additional injections and rate of surgery after treatment with TEI, to determine the short-term (cost)effectiveness of TEI on physical and psychological patient outcome measures, and to determine the rate of complications associated with TEI Study design: Prospective cohort study Study population: Patients that are scheduled for TEI as part of usual care suffering from a new episode of lumbar radiculopathy Main study parameters/endpoints: leg and back pain scores at baseline, 30 minutes, 2 and 6 weeks after treatment. ODI, HADS, Quality of Life and PCI at baseline, 2 and 6 weeks after treatment. Perceived recovery at 2 and 6 weeks after treatment. Usage of healthcare at baseline, 2 and 6 weeks after treatment.


Description:

Data collection schedule Baseline Weeks of follow-up 30 min. Day 4 Week 2 Week 6 Demographic data ✓ NRS leg pain ✓ ✓ ✓ ✓ NRS back pain ✓ ✓ ✓ ✓ ODI ✓ ✓ ✓ HADS ✓ ✓ ✓ QoL VAS ✓ ✓ ✓ PCI ✓ ✓ ✓ Likert score ✓ ✓ Adjuvant therapy ✓ ✓ ✓ TEI data ✓ ✓


Recruitment information / eligibility

Status Recruiting
Enrollment 388
Est. completion date December 2026
Est. primary completion date December 2026
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Diagnosis of unilateral lumbar radiculopathy secondary to LDH or one-level spinal stenosis - Diagnosis supported by magnetic resonance imaging (MRI) findings - Scheduled appointment for TEI - Access to e-mail - Signed informed consent Exclusion Criteria: - Diagnosis of unilateral lumbar radiculopathy secondary to LDH or one-level spinal stenosis - Age under 18 years - Severe multisegmental spinal disease - Anatomical abnormalities that may complicate the procedure technically (e.g. severe scoliosis) - Active malignancy or infectious disease - Use of immunosuppressive drugs - Use of systemic corticosteroids in preceding 3 months - Previous treatment with TEI for current episode of lumbar radiculopathy - History of lower back surgery at the same lumbar level - Circumstances that prevent treatment with TEI (e.g. use of anticoagulants that cannot be temporarily discontinued, allergy against steroids or local anaesthetic) - Pregnancy - Major language barrier

Study Design


Intervention

Drug:
Transforaminal Epidural Injection
Injections above L3 will contain 1,5 ml lidocaine 1% and 10 mg dexamethasone and injections at L3 or below will contain 1,5 ml lidocaine 2% and 40mg methylprednisolone acetate in accordance with current Dutch anesthesiologic guidelines for usual care.

Locations

Country Name City State
Netherlands Spaarne Gasthuis Haarlem

Sponsors (2)

Lead Sponsor Collaborator
EJAVerheijen Spaarne Gasthuis

Country where clinical trial is conducted

Netherlands, 

References & Publications (6)

Billy GG, Lin J, Gao M, Chow MX. Predictive Factors of the Effectiveness of Caudal Epidural Steroid Injections in Managing Patients With Chronic Low Back Pain and Radiculopathy. Clin Spine Surg. 2017 Jul;30(6):E833-E838. doi: 10.1097/BSD.0000000000000454. — View Citation

Cyteval C, Fescquet N, Thomas E, Decoux E, Blotman F, Taourel P. Predictive factors of efficacy of periradicular corticosteroid injections for lumbar radiculopathy. AJNR Am J Neuroradiol. 2006 May;27(5):978-82. — View Citation

Lee JW, Kim SH, Lee IS, Choi JA, Choi JY, Hong SH, Kang HS. Therapeutic effect and outcome predictors of sciatica treated using transforaminal epidural steroid injection. AJR Am J Roentgenol. 2006 Dec;187(6):1427-31. doi: 10.2214/AJR.05.1727. — View Citation

McCormick Z, Cushman D, Casey E, Garvan C, Kennedy DJ, Plastaras C. Factors associated with pain reduction after transforaminal epidural steroid injection for lumbosacral radicular pain. Arch Phys Med Rehabil. 2014 Dec;95(12):2350-6. doi: 10.1016/j.apmr.2014.07.404. Epub 2014 Aug 7. — View Citation

Sencan S, Celenlioglu AE, Asadov R, Gunduz OH. Predictive factors for treatment success of transforaminal epidural steroid injection in lumbar disc herniation-induced sciatica. Turk J Med Sci. 2020 Feb 13;50(1):126-131. doi: 10.3906/sag-1908-167. — View Citation

Vroomen PC, de Krom MC, Knottnerus JA. Predicting the outcome of sciatica at short-term follow-up. Br J Gen Pract. 2002 Feb;52(475):119-23. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Numerical Rating Scale Leg Pain The NRS score for leg pain 2 weeks
Secondary Numerical Rating Scale Leg Pain The NRS score for leg pain 30 minutes after treatment
Secondary Numerical Rating Scale Leg Pain The NRS score for leg pain 6 weeks
Secondary Numerical Rating Scale Back Pain The NRS score for back pain 30 minutes after treatment
Secondary Numerical Rating Scale Back Pain The NRS score for back pain 2 weeks
Secondary Numerical Rating Scale Back Pain The NRS score for back pain 6 weeks
Secondary Oswestry Disability Index The ODI score for functionality 2 weeks
Secondary Oswestry Disability Index The ODI score for functionality 6 weeks
Secondary Global Perceived Effect The degree of patient satisfaction from experienced recovery on a Likert scale 2 weeks
Secondary Global Perceived Effect The degree of patient satisfaction from experienced recovery on a Likert scale 6 weeks
Secondary Hospital Anxiety and Depression Scale The HADS score for assessment of anxiety and depression 2 weeks
Secondary Hospital Anxiety and Depression Scale The HADS score for assessment of anxiety and depression 6 weeks
Secondary Pain Coping Inventory Assessment of the pain coping mechanisms of the patient 2 weeks
Secondary Pain Coping Inventory Assessment of the pain coping mechanisms of the patient 6 weeks
Secondary Visual Analogue Scale Quality of Life The VAS for assessment of Quality of Life 2 weeks
Secondary Visual Analogue Scale Quality of Life The VAS for assessment of Quality of Life 6 weeks
Secondary Use of pain medication and physical therapy Use of pain medication and physical therapy 2 weeks
Secondary Use of pain medication and physical therapy Use of pain medication and physical therapy 6 weeks
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