Short Versus Long Post-Operative Restrictions Following Lumbar Discectomy

NCT ID: NCT01363830

Last Updated: 2013-10-22

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-08-31

Study Completion Date

2013-12-31

Brief Summary

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Post-operative restrictions following lumbar discectomy is a controversial topic. While the most widely accepted protocol restricts bending, lifting, and twisting for four to six weeks following discectomy, a number of studies support an early return to full activity without restriction. Since the goal of discectomy is to promptly provide pain relief and a return to a fully active lifestyle, perhaps post-operative restrictions are more hindering than beneficial.

Hypothesis: Post-operative restrictions following lumbar discectomy do not influence reherniation rate.

Specific Aim 1: To compare the reherniation rates between the 6-weeks of restriction and the 2-weeks of restriction groups.

Specific Aim 2: To determine the return to full activity and return to work dates of both the 6-weeks of restriction and 2-weeks of restriction groups.

Specific Aim 3: To assess the health outcomes of both the 6-weeks of restriction and 2-weeks of restriction groups.

Detailed Description

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Upon enrollment, subjects will be randomized to the "6-weeks of restriction" or "2-weeks of restriction" group. Subjects will also be asked to provide/complete:

* demographical information
* VAS back and leg score
* Modified Oswestry questionnaire

All of the surgeries will be performed using a so-called limited discectomy in which the herniated disc fragment is removed without an aggressive disc space curettage. Prior to surgery, the subjects' discs will be classified by the Primary Investigator and Site Responsible Investigator on a T-2 weighted MRI according to the Carragee Disc Herniation Classification system.

The discs will be reassessed intraoperatively by the surgeon to confirm the assigned classification. In addition, a radiologist will review a random sampling set of discs on T-2 weighted MRI to eliminate bias and validate the classifications.

Subjects will be followed for a 2 year time period with study visits at 2 weeks, 6 weeks, 3 months, 1 year, and 2 years. At every follow-up visit, the following will be completed and/or documented:

* A reherniation (any clinical symptoms of a reherniation will be verified and documented by MRI)
* Return to full activity and/or work (date)
* VAS back and leg score
* Modified Oswestry questionnaire

Conditions

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Lumbar Disc Herniation

Keywords

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Disc lumbar herniation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Two-Week Post-Operative Restriction

Restrict bending, lifting, and twisting for two-weeks following discectomy.

Group Type EXPERIMENTAL

Two-Week Post-Operative Restriction

Intervention Type BEHAVIORAL

Surgeon recommends the patient restrict bending, lifting, and twisting for two-weeks following discectomy.

Six-Week Post-Operative Restriction

Restrict bending, lifting, and twisting for six-weeks following discectomy.

Group Type ACTIVE_COMPARATOR

Six-Week Post-Operative Restriction

Intervention Type BEHAVIORAL

Surgeon recommends patient restrict bending, lifting, and twisting for six-weeks following discectomy.

Interventions

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Two-Week Post-Operative Restriction

Surgeon recommends the patient restrict bending, lifting, and twisting for two-weeks following discectomy.

Intervention Type BEHAVIORAL

Six-Week Post-Operative Restriction

Surgeon recommends patient restrict bending, lifting, and twisting for six-weeks following discectomy.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* English speaking
* single level lumbar disc herniation
* surgical candidate
* no previous lumbar surgery
* primary radicular pain

Exclusion Criteria

* Less than 18 years of age
* Non-English speaking
* Multi-level lumbar disc herniation
* Disc reherniation
* Previous lumbar surgery
* Primary low back pain
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Massachusetts General Hospital

OTHER

Sponsor Role collaborator

Beth Israel Deaconess Medical Center

OTHER

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Christopher Bono

Christopher M. Bono, MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christopher M Bono, M.D.

Role: PRINCIPAL_INVESTIGATOR

Brigham & Women's Hospital / Harvard Medical School

Locations

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Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Brigham & Women's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Dana A Leonard

Role: CONTACT

Phone: 617-525-8761

Email: [email protected]

Christopher M Bono, M.D.

Role: CONTACT

Phone: 617-732-7238

Email: [email protected]

Facility Contacts

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Rishabh D Phukan

Role: primary

Andrew White, M.D.

Role: primary

Dana A Leonard, B.A.

Role: primary

Other Identifiers

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2009P001125

Identifier Type: -

Identifier Source: org_study_id