The MiDAS ENCORE Study

NCT ID: NCT02093520

Last Updated: 2017-12-06

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

302 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2017-10-31

Brief Summary

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Study Objective: To compare patient outcomes following treatment with either the MILD procedure or epidural steroid injections (ESIs) in patients with painful lumbar spinal stenosis exhibiting neurogenic claudication and having verified ligamentum flavum hypertrophy as a contributing factor.

Detailed Description

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Conditions

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Spinal Stenosis, Lumbar Region, With Neurogenic Claudication

Keywords

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Lumbar Spinal Stenosis Spinal Stenosis Neurogenic Claudication

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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MILD

The MILD procedure is an image-guided minimally-invasive lumbar decompression

Group Type ACTIVE_COMPARATOR

MILD Procedure

Intervention Type PROCEDURE

The percutaneous procedure is performed under fluoroscopic guidance to effect a lumbar decompression with minimal surrounding tissue and bone disruption. The mild® Device Kit is utilized to access, capture and remove bone and tissue.

Epidural Steroid Injection (ESI)

An epidural steroid injection (ESI) is a combination of a corticosteroid with a local anesthetic pain relief medicine.

Group Type ACTIVE_COMPARATOR

Epidural Steroid Injection

Intervention Type DRUG

Injection of epidural steroids into the lumbar spine

Interventions

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MILD Procedure

The percutaneous procedure is performed under fluoroscopic guidance to effect a lumbar decompression with minimal surrounding tissue and bone disruption. The mild® Device Kit is utilized to access, capture and remove bone and tissue.

Intervention Type PROCEDURE

Epidural Steroid Injection

Injection of epidural steroids into the lumbar spine

Intervention Type DRUG

Other Intervention Names

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MILD lumbar decompression ESI

Eligibility Criteria

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Inclusion Criteria

1. 65 years or older and a Medicare beneficiary.
2. Patients experiencing neurogenic claudication symptoms for at least 3 months duration which has failed to respond or poorly responded to physical therapy, home exercise programs, and oral analgesics.
3. LSS with neurogenic claudication diagnosed via:

1. Symptomatic diagnosis and
2. Radiologic evidence of LSS with unilateral or bilateral ligamentum flavum \>2.5mm confirmed by pre-op MRI or CT performed within 12 months of baseline visit.
4. Patients with comorbid conditions commonly associated with spinal stenosis, such as osteophytes, facet hypertrophy, minor spondylolisthesis, foraminal stenosis, and/or disk protrusion may be included unless the treating physician has determined that the condition is too advanced.
5. Available to complete 6 month and one year follow-up visits.

Exclusion Criteria

1. ODI Score \< 31 (0-100 ODI Scale).
2. NPRS Score \< 5 (0-10 NPRS Scale).
3. Prior surgery at any treatment level.
4. History of recent spinal fractures with current related pain symptoms.
5. Patients with Grade III or higher spondylolisthesis.
6. Motor deficit or disabling back and/or leg pain from causes other than LSS neurogenic claudication (e.g., acute compression fracture, metabolic neuropathy, or vascular claudication symptoms, etc.).
7. Unable to walk ≥ 10 feet unaided before being limited by pain. In this context, 'unaided' means without the use of a cane, walker, railing, wall, another person or any other means of walking assistance.
8. Patients previously randomized and/or treated in this clinical study.
9. Patients that have previously received the MILD procedure.
10. ESI during eight weeks prior to study enrollment.
11. Epidural lipomatosis (if it is deemed to be a significant contributor of canal narrowing by the physician).
12. On (or pending) Workman's Compensation or known to be considering litigation associated with back pain.
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vertos Medical, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ramsin Benyamin, MD

Role: PRINCIPAL_INVESTIGATOR

AAPM; ASIPP; ISIS; ASA

Peter Staats, MD

Role: PRINCIPAL_INVESTIGATOR

AAPM; ASIPP; ASA

Locations

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Synovation Medical Group

Chula Vista, California, United States

Site Status

Spine Intervention Medical Group/Fresno Surgical Hospital

Fresno, California, United States

Site Status

The Spine Institute

Murrieta, California, United States

Site Status

Newport Beach Headache and Pain

Newport Beach, California, United States

Site Status

Millennium Pain Center

Bloomington, Illinois, United States

Site Status

Frankfort Pain Clinic

Frankfort, Kentucky, United States

Site Status

MI Interventional Pain Center

Cherry Island, Michigan, United States

Site Status

Michigan Pain Specialist

Ypsilanti, Michigan, United States

Site Status

Mayo Clinic Pain Management

Rochester, Minnesota, United States

Site Status

Premier Pain

Shrewsbury, New Jersey, United States

Site Status

Southern Spine Institute

Mt. Pleasant, South Carolina, United States

Site Status

SC Spine and Pain Specialists

Myrtle Beach, South Carolina, United States

Site Status

Countries

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United States

References

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Staats PS, Chafin TB, Golovac S, Kim CK, Li S, Richardson WB, Vallejo R, Wahezi SE, Washabaugh EP 3rd, Benyamin RM; MiDAS ENCORE Investigators. Long-Term Safety and Efficacy of Minimally Invasive Lumbar Decompression Procedure for the Treatment of Lumbar Spinal Stenosis With Neurogenic Claudication: 2-Year Results of MiDAS ENCORE. Reg Anesth Pain Med. 2018 Oct;43(7):789-794. doi: 10.1097/AAP.0000000000000868.

Reference Type DERIVED
PMID: 30199512 (View on PubMed)

Benyamin RM, Staats PS, MiDAS Encore I. MILD(R) Is an Effective Treatment for Lumbar Spinal Stenosis with Neurogenic Claudication: MiDAS ENCORE Randomized Controlled Trial. Pain Physician. 2016 May;19(4):229-42.

Reference Type DERIVED
PMID: 27228511 (View on PubMed)

Staats PS, Benyamin RM; MiDAS ENCORE Investigators. MiDAS ENCORE: Randomized Controlled Clinical Trial Report of 6-Month Results. Pain Physician. 2016 Feb;19(2):25-38.

Reference Type DERIVED
PMID: 26815247 (View on PubMed)

Other Identifiers

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MiDAS ENCORE

Identifier Type: -

Identifier Source: org_study_id