Effectiveness of Caudal Epidural Injections in Treatment of Chronic Low Back and Lower Extremity Pain

NCT ID: NCT00370799

Last Updated: 2013-08-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

EARLY_PHASE1

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2010-03-31

Brief Summary

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To demonstrate clinically significant improvements or lack thereof in the caudal epidural patients with our without steroids.

To evaluate differences in outcomes in patients receiving steroids compared to those patients randomized to the local anesthetic group who did not receive steroids.

To assess improvements among patients and compare steroid groups with each other and local anesthetic group.

To evaluate and compare the adverse event profile in all patients

Detailed Description

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Patients with chronic low back pain of at least 6 months duration, non-responsive to conservative management with NSAIDS, physical therapy or chiropractic treatment exercises.

A single-center, prospective, controlled, double blinded, randomized study of patients in 4 groups.

* Group 1. local anesthetics only
* Group 2. local anesthetic with 6mg of non-particulate Celestone
* Group 3. local anesthetic with 6 mg of brand name Celestone
* Group 4. local anesthetic with 40 mg of alcohol-free DepoMedrol

All patients will be unblinded in 12 months.

Non-responsive patients will be unblinded after 3 months and will be crossed over to a different group

Conditions

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Low Back Pain

Keywords

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Caudal Epidural injections lumbar disc herniation spinal stenosis discogenic pain post-lumbar laminectomy syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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local anesthetic

Group 1. local anesthetics only

Group Type ACTIVE_COMPARATOR

Caudal epidural injection

Intervention Type DRUG

group 1: Caudal epidural injection local anesthetics only

Local anesthetic with generic Celestone

Group 2. local anesthetic with 6mg of non-particulate Celestone

Group Type ACTIVE_COMPARATOR

Caudal Epidural Injection with generic Celestone

Intervention Type DRUG

Group 2. Caudal Epidural Injection local anesthetic with 6mg of non-particulate Celestone

Local anesthetic with Celestone

Group 3. local anesthetic with 6 mg of brand nameCelestone

Group Type ACTIVE_COMPARATOR

Caudal Epidural Injection with Celestone

Intervention Type DRUG

Group 3. Caudal Epidural Injection with local anesthetic with 6 mg of brand name Celestone

Local anesthetic with DepoMedrol

Group 4. local anesthetic with 40 mg of alcohol-free DepoMedrol

Group Type ACTIVE_COMPARATOR

Caudal Epidural Injection with DepoMedrol

Intervention Type DRUG

Group 4. local anesthetic with 40 mg of alcohol-free DepoMedrol

Interventions

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Caudal epidural injection

group 1: Caudal epidural injection local anesthetics only

Intervention Type DRUG

Caudal Epidural Injection with generic Celestone

Group 2. Caudal Epidural Injection local anesthetic with 6mg of non-particulate Celestone

Intervention Type DRUG

Caudal Epidural Injection with Celestone

Group 3. Caudal Epidural Injection with local anesthetic with 6 mg of brand name Celestone

Intervention Type DRUG

Caudal Epidural Injection with DepoMedrol

Group 4. local anesthetic with 40 mg of alcohol-free DepoMedrol

Intervention Type DRUG

Other Intervention Names

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Group 1 Group 2 Group 3 Group 4

Eligibility Criteria

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Inclusion Criteria

* At least 18 years of age
* History of chronic, function-limiting low back pain of at least 6 months duration
* Able to give voluntary, written informed consent to participate,
* Able to understand the investigation, cooperate with the procedures, and willing to return for follow-up
* No recent surgical procedures within last three months

Exclusion Criteria

* Cauda Equina symptoms and/or compressive radiculopathy
* Narcotic use of no greater than 100mg/day hydrocodone, 60mg Methadone. or 100mg morphine
* Uncontrolled major Depression or uncontrolled psychiatric disorder
* Uncontrolled or acute medical illnesses
* Chronic severe conditions that could interfere with outcome assessments
* Women who are pregnant or lactating
* Subjects who have participated in a clinical study with an investigational product within 30 days of enrollment
* Patients with multiple complaints involving concomitant hip osteoarthritis
* Inability to achieve proper positioning and inability to understand informed consent and protocol
* History of adverse reaction to local anesthetic or anti-inflammatory drugs and history of gastrointestinal bleeding or ulcers
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pain Management Center of Paducah

OTHER

Sponsor Role lead

Responsible Party

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Laxmaiah Manchikanti, MD

Medical Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Laxmaiah Manchikanti, MD

Role: PRINCIPAL_INVESTIGATOR

Ambulatory Surgery Center

Locations

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Ambulatory Surgery Center

Paducah, Kentucky, United States

Site Status

Countries

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United States

References

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Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. Effect of fluoroscopically guided caudal epidural steroid or local anesthetic injections in the treatment of lumbar disc herniation and radiculitis: a randomized, controlled, double blind trial with a two-year follow-up. Pain Physician. 2012 Jul-Aug;15(4):273-86.

Reference Type DERIVED
PMID: 22828681 (View on PubMed)

Manchikanti L, Cash KA, McManus CD, Pampati V, Smith HS. One-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections with or without steroids in managing chronic discogenic low back pain without disc herniation or radiculitis. Pain Physician. 2011 Jan-Feb;14(1):25-36.

Reference Type DERIVED
PMID: 21267039 (View on PubMed)

Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Management of pain of post lumbar surgery syndrome: one-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections. Pain Physician. 2010 Nov-Dec;13(6):509-21.

Reference Type DERIVED
PMID: 21102963 (View on PubMed)

Other Identifiers

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protocol 10

Identifier Type: -

Identifier Source: org_study_id