A Safety and Effectiveness Trial of Spinal Cord Stimulation of the Dorsal Root Ganglion for Chronic Lower Limb Pain

NCT ID: NCT01923285

Last Updated: 2020-11-24

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

152 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-08-31

Study Completion Date

2016-09-30

Brief Summary

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The purpose of this study is to evaluate the safety and effectiveness of the AXIUM Neurostimulator System for the treatment of chronic lower limb pain in persons diagnosed with Complex Regional Pain Syndrome (CRPS) or Peripheral Causalgia (PC).

Detailed Description

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The ACCURATE study is a prospective, randomized, controlled, multicenter clinical trial designed to assess the safety and efficacy of the Spinal Modulation Axium Neurostimulator System as an aid in the management of chronic, intractable pain of the lower limbs, including unilateral or bilateral pain associated with one of the following conditions: Complex Regional Pain Syndrome (CRPS) or Peripheral Causalgia (also referred to as CRPS Type II).

Enrolled subjects were diagnoses with CRPS or peripheral causalgia; experienced pain for at least six months; and failed to achieve adequate pain relief from at least two prior pharmacologic treatments.

All subjects had a temporary trial neurostimulator (TNS). If the subject was a treatment success at the end of TNS they were scheduled for the fully implantable neurostimulator (INS) implant procedure. If not, subjects were exited from the study.

Conditions

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Chronic Lower Limb Pain

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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AXIUM Neurostimulator System

The AXIUM Neurostimulator System is an investigational spinal cord stimulation device that is designed to stimulate the dorsal root ganglion (DRG) of the spine located on the back surface of the spinal cord where nerves exit the backbone. The device has 2 parts that are placed surgically (implanted) : 1) a pulse generator which is placed under the skin in the buttocks or abdomen, and 2) up to four wires (leads) that have one end attached to the pulse generator, and the other end secured to the tissue near the target treatment area.

Group Type EXPERIMENTAL

AXIUM Neurostimulator System

Intervention Type DEVICE

Control Spinal Cord Stimulation Device

The Control Spinal Cord Stimulation Device is a commercially available spinal cord stimulator indicated for the treatment of chronic lower limb pain.

Group Type ACTIVE_COMPARATOR

Control Spinal Cord Stimulation Device

Intervention Type DEVICE

Interventions

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AXIUM Neurostimulator System

Intervention Type DEVICE

Control Spinal Cord Stimulation Device

Intervention Type DEVICE

Other Intervention Names

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DRG Stimulation SCS

Eligibility Criteria

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Inclusion Criteria

1. Subject is male or female between the ages of 22 and 75 years
2. Subject is able and willing to comply with the follow-up schedule and protocol
3. Subject has chronic, intractable pain of the lower limb(s) for at least 6 months
4. Subjects are diagnosed with complex regional pain syndrome (CRPS) and/or peripheral causalgia
5. Subjects have a minimum Visual Analog Scale (VAS) greater than or equal to 60 mm in the area of greatest pain in the lower limbs.
6. Subject has failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drugs classes
7. Subject has had stable neurologic function in the past 30 days
8. In the opinion of the Investigator, the subject is psychologically appropriate for the implantation of an active implantable medical device
9. Subject is able to provide written informed consent

Exclusion Criteria

1. Back pain is the greatest region of pain as measured on the baseline VAS.
2. Female subject of childbearing potential is pregnant/nursing, plans to become pregnant or is unwilling to use approved birth control
3. Subject has exhibited escalating or changing pain condition within the past 30 days as evidenced by Investigator examination
4. Subject is currently involved in medically related litigation, including workers compensation
5. Subject has had corticosteroid therapy at an intended site of stimulation within the past 30 days
6. Subject's pain medication(s) dosage(s) are not stable for at least 30 days
7. Subject has had radiofrequency treatment of an intended target Dorsal Root Ganglion within the past 3 months
8. Subject has previously failed spinal cord stimulation therapy
9. Subject currently has an active implantable device including implantable cardioverter defibrillator, pacemaker, spinal cord stimulator or intrathecal drug pump or subject requires magnetic resonance imaging (MRIs) or diathermy
10. Subject has pain only within a cervical distribution
11. Subject has cognitive, physical or sensory impairment that, in the opinion of the Investigator, may limit their ability to operate the device
12. Subject currently has an indwelling device that may pose an increased risk of infection
13. Subject currently has an active systemic infection.
14. Subject has, in the opinion of the investigator, a medical comorbidity that contraindicates placement of an active medical device
15. Subject has participated in another clinical investigation within 30 days
16. Subject has a coagulation disorder or uses anticoagulants that, in the opinion of the Investigator, precludes participation
17. Subject has been diagnosed with cancer in the past 2 years
18. Imaging (MRI, CT, x-ray) findings within the last 12 months that, in the Investigator's opinion, contraindicates lead placement
19. Subject is a prisoner
Minimum Eligible Age

22 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robyn Capobianco, PhD

Role: STUDY_DIRECTOR

Abbott

Locations

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HOPE Research - TPC

Phoenix, Arizona, United States

Site Status

Pain Clinic of Monterey Bay

Aptos, California, United States

Site Status

Coastal Pain Research

Carlsbad, California, United States

Site Status

Neurovations, Inc.

Napa, California, United States

Site Status

Newport Beach Headache and Pain

Newport Beach, California, United States

Site Status

Eisenhower Medical Center

Rancho Mirage, California, United States

Site Status

Orthopaedic Pain Specialists

Santa Monica, California, United States

Site Status

IPM Medical Group, Inc.

Walnut Creek, California, United States

Site Status

Florida Pain Institute

Merritt Island, Florida, United States

Site Status

Holy Cross Hospital Orthopedic Institute

Oakland Park, Florida, United States

Site Status

Drug Studies of America

Marietta, Georgia, United States

Site Status

Comprehensive Pain and Rehabilitation

Pascagoula, Mississippi, United States

Site Status

Pain Management Associates

Independence, Missouri, United States

Site Status

HOPE Research - LVSP

Las Vegas, Nevada, United States

Site Status

Premier Pain Center

Shrewsbury, New Jersey, United States

Site Status

The Center for Clinical Research

Winston-Salem, North Carolina, United States

Site Status

Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status

Clinical Trials of South Carolina

Charleston, South Carolina, United States

Site Status

Southeastern Spine Institute

Mt. Pleasant, South Carolina, United States

Site Status

Houston Pain Centers

Houston, Texas, United States

Site Status

Center for Pain Relief

Charleston, West Virginia, United States

Site Status

Center for Pain Relief Tri-State

Huntington, West Virginia, United States

Site Status

Countries

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United States

References

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Levy RM, Mekhail N, Kramer J, Poree L, Amirdelfan K, Grigsby E, Staats P, Burton AW, Burgher AH, Scowcroft J, Golovac S, Kapural L, Paicius R, Pope J, Samuel S, McRoberts WP, Schaufele M, Kent AR, Raza A, Deer TR. Therapy Habituation at 12 Months: Spinal Cord Stimulation Versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Type I and II. J Pain. 2020 Mar-Apr;21(3-4):399-408. doi: 10.1016/j.jpain.2019.08.005. Epub 2019 Sep 5.

Reference Type DERIVED
PMID: 31494275 (View on PubMed)

Other Identifiers

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03-SMI-2012

Identifier Type: -

Identifier Source: org_study_id