Effectiveness and Safety of Pharmacopuncture Therapy for Patients With Lumbar Spinal Stenosis

Lumbar Spinal Stenosis Clinical Trial

Official title:

Effectiveness and Safety of Pharmacopuncture Therapy for Patients With Lumbar Spinal Stenosis : Multicentered, Pragmatic Randomized Controlled, Parallel Grouped Study

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05242497
• Other study ID #: JS-CT-2021-14
• Status: Active, not recruiting
• Phase: N/A
• Start date: April 13, 2022
• Est. completion date: October 25, 2024

Study information

• Verified date: March 2024
• Source: Jaseng Medical Foundation
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is 1:1 pragmatic randomized controlled trials in a parallel-grouped, multi-centered design that investigated pharmacopuncture therapy for patients with lumbar spinal stenosis, compared to the conservative treatments including physiotherapy and pharmacological treatments.

Description:

This is 1:1 pragmatic randomized controlled trials in a parallel-grouped, multi-centered design that investigated pharmacopuncture therapy for patients with lumbar spinal stenosis, compared to the conservative treatments including physiotherapy and pharmacological treatments. The physician will decide specific location, type, and doses of pharmacopuncture therapy or conservative treatments according to each participants' disease conditions, respectively. The researcher will record concurrently.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 98
• Est. completion date: October 25, 2024
• Est. primary completion date: January 19, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 19 Years to 69 Years

Eligibility

Inclusion Criteria:

1. Diagnosed with lumbar spinal stenosis based on radiology including computed tomography or magnetic resonance imaging.

2. Clear neurogenic claudication symptoms existed (symptoms aggravated with walking, and alleviated upon resting in lumbar flexion position).

3. reported radiating leg pain or low back pain (LBP) with intensity of NRS =5

4. Between the age of 19 and 69 years old.

5. Participants who agreed to participate the study and voluntarily signed the informed consent form.

Exclusion Criteria:

1. Patients with vascular claudication

2. Patients with pathologies of non-spinal origin that may cause LBP or radiating leg pain (e.g. spinal tumor, fracture)

3. Patients with soft tissue pathologies that may cause LBP or radiating leg pain (e.g. tumor, fibromyalgia, rheumatoid arthritis, gout)

4. Patients with other systemic diseases that may interfere with treatment effect or outcome interpretation

5. Patients who administrate those prescribed medicine that may interfere with interpretation of the result (e.g. corticosteroids, immunosuppressants, physchotropic drugs)

6. Patients for whom pharmacopuncture treatment may be inappropriate or unsafe (e.g. hemorrhagic diseases, blood clotting disorders, history of anti-coagulation medicine intake, serious diabetes with risk of infection)

7. Patients who were treated with one of the following intervention within the past week; medicine that may potentially influence pain such as NSAIDs (nonsteroidal antiinflammatory drugs), pharmacopuncture, or physical therapies.

8. Pregnant patients or patients planning pregnancy

9. Patients with medical history of spinal surgery within the past 3 months

10. Previous participation in other clinical studies within 1 month of current study enrollment, or plans to participate in other clinical studies during participation (including follow-up period) of the current study after study enrollment

11. Patients unable to fill out study participation consent form

12. Patients deemed unsuitable for study participation as assessed by the researchers

Related Conditions & MeSH terms

• Constriction, Pathologic
• Lumbar Spinal Stenosis
• Spinal Stenosis

Intervention

Procedure:
• pharmacopuncture
This is a pragmatic randomized controlled trials, so the physicians will choose pharmacopuncture treatment, including the type and doses, according to each participant's conditions. The researcher will record the specific intervention precisely and concurrently.
• conservative treatments (including physiotherapy)
This is a pragmatic randomized controlled trials, so the physicians will choose conservative treatment, including physiotherapy and pharmacological treatment, according to each participant's conditions. The researcher will record the specific intervention precisely and concurrently.

Locations

Country	Name	City	State
Korea, Republic of	Bucheon Jaseng Hospital of Korean Medicine	Bucheon	Gyeonggi Province
Korea, Republic of	Haeundae Jaseng Hospital of Korean Medicine	Busan
Korea, Republic of	Daejeon Jaseng Hospital of Korean Medicine	Daejeon
Korea, Republic of	Dongguk University Bundang Oriental Hospital	Seoul	Bundang-gu, Seongnam-si
Korea, Republic of	Jaseng Hospital of Korean Medicine	Seoul	Gangnam-Gu
Korea, Republic of	Kyung Hee University Korean Medicine Hospital	Seoul	Dongdaemun-gu
Korea, Republic of	Kyung Hee University Korean Medicine Hospital at Gangdong	Seoul	Gangdong-gu

Sponsors (1)

Lead Sponsor	Collaborator
Jaseng Medical Foundation

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Numeric rating scale (NRS)	NRS is a pain scale in which the patients indicates their subjective pain as a whole number from 0 to 10, where 0 indicates 'no pain or discomfort' and 10 indicates 'the most severe pain and discomfort imaginable'. The NRS of major painful site, which was chosen between low back and radiation pain in lower extremities, will be reported.	week 13
Secondary	Numeric rating scale (NRS) of low back pain and radiating pain	NRS is a pain scale in which the patients indicates their subjective pain as a whole number from 0 to 10, where 0 indicates 'no pain or discomfort' and 10 indicates 'the most severe pain and discomfort imaginable'.	week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 25, 53
Secondary	Visual analogue scale (VAS) of low back pain and radiating pain	The patient indicates their pain severity from minimum 0 to maximum 100, which is a higher score means a worse outcome. VAS of low back pain and radiating leg pain will be reported.	week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 25, 53
Secondary	Walking distance	Claudication-free walking distance and maximal walking distance will be evaluated.	week 1, 5, 9, 13, 25, 53
Secondary	Zurich Claudication Questionnaire (ZCQ)	ZCQ is a lumbar spinal stenosis-specific patient reported outcome, which evaluate the disease severity, functional scale and satisfaction at the treatment.	week 1, 5, 9, 13, 25, 53
Secondary	Oswestry disability index (ODI)	ODI is a functional disability questionnaire. The possible range of each item score is 0 to 5. Total score range is 0 (better outcome) to 100 (worse outcome).	week 1, 5, 9, 13, 25, 53
Secondary	PGIC	Participants rate the improvement after treatment on a 7-point Likert scale (1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.)	week 13, 25, 53
Secondary	Short Form-12 Health Survey version 2 (SF-12 v2)	The SF-12 consists of 12 questions across 8 domains, and higher scores indicate better health-related quality of life.	week 1, 5, 9, 13, 25, 53
Secondary	EuroQol-5 Dimension (EQ-5D-5L)	The EQ-5D-5L consists of 5 questions (mobility, self-care, usual activities, pain, anxiety/depression) that ask about the current state of health, and answers each question with 5 likert. (1=I have no problems about, 2=I have slight problems about, 3=I have moderate problems about, 4=I have severe problems about, 5=I am unable to about)	week 1, 5, 9, 13, 25, 53