Evaluation of Spinal Mobility Reeducation in Patients Treated for a Lumbar Spinal Stenosis After Epidural Infiltration

NCT ID: NCT02610335

Last Updated: 2020-10-26

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

TERMINATED

Clinical Phase

NA

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-15

Study Completion Date

2018-06-01

Brief Summary

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In actual practice the patients with mild or moderate lumbar spinal stenosis symptoms receive an epidural infiltration and participate in kyphosis reeducation in first intention. Yet the kyphosis reeducation did not show a real profit in the time compared with the natural evolution of the pathology. The study assume that the spinal mobility reeducation will reduce the incidence of pain recurrences compared with the classic kyphosis reeducation.

Detailed Description

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The standard treatment of lumbar spinal stenosis is the lumbar canal recalibration surgery which presents co-morbidity factors and risks of post-operative complications. The non-invasive methods are a good alternative compared with the surgery : the patients medically treated present few damages and the results of the postponed surgery are equivalent to the immediate surgery. That is why a non-surgical treatment is proposed in first intention to the patients with mild or moderate symptoms : this treatment associates an epidural infiltration and a kyphosis reeducation.

Yet the kyphosis reeducation did not show a real profit in the time compared with the natural evolution of the pathology. The benefits of the infiltration are lost three months after this one in 80 % of the cases. A return to physical activity and a restored spinal mobility would improve the duration of the infiltration effect. The objective is then to compare the efficiency of a spinal mobility reeducation program versus a kyphosis reeducation program in patients with acquired and central lumbar spinal stenosis. It is a prospective, monocentric, randomized, superiority and parallel-group study :

* group C (control group) : kyphosis reeducation + patient education + auto-reeducation at home,
* group M (test group) : spinal mobility reeducation + patient education + auto-reeducation at home.

Conditions

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Lumbar Spinal Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control group (C)

Kyphosis reeducation + patient education + auto-reeducation at home

Group Type ACTIVE_COMPARATOR

Control group (C)

Intervention Type OTHER

* kyphosis reeducation on Huber platform during 2 weeks,
* patient education : on physiopathology of the lumbar spinal stenosis and treatments as well as healthy lifestyle and prevention (plans of anatomy, plastic column, slides of medical imaging),
* flexibility exercises, stretching exercises and abdominal muscles exercises : to continue at home (the exercises will be reported on a book that will be given to the patient),
* exercises on cycle ergometer or walking on treadmill : to continue at home.

Test group (M)

Spinal mobility reeducation + patient education + auto-reeducation at home.

Group Type OTHER

Test group

Intervention Type OTHER

* spinal mobility reeducation on Huber platform during 2 weeks,
* patient education : on physiopathology of the lumbar spinal stenosis and treatments as well as healthy lifestyle and prevention (plans of anatomy, plastic column, slides of medical imaging),
* flexibility exercises and mobilization exercises : to continue at home (the exercises will be reported on a book that will be given to the patient),
* exercises on cycle ergometer or walking on treadmill : to continue at home.

Interventions

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Control group (C)

* kyphosis reeducation on Huber platform during 2 weeks,
* patient education : on physiopathology of the lumbar spinal stenosis and treatments as well as healthy lifestyle and prevention (plans of anatomy, plastic column, slides of medical imaging),
* flexibility exercises, stretching exercises and abdominal muscles exercises : to continue at home (the exercises will be reported on a book that will be given to the patient),
* exercises on cycle ergometer or walking on treadmill : to continue at home.

Intervention Type OTHER

Test group

* spinal mobility reeducation on Huber platform during 2 weeks,
* patient education : on physiopathology of the lumbar spinal stenosis and treatments as well as healthy lifestyle and prevention (plans of anatomy, plastic column, slides of medical imaging),
* flexibility exercises and mobilization exercises : to continue at home (the exercises will be reported on a book that will be given to the patient),
* exercises on cycle ergometer or walking on treadmill : to continue at home.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* age \> 50 years,
* central, acquired and multi-staged lumbar spinal stenosis,
* pain since at least three months,
* radicular pains higher than the lumbar pains,
* walking distance \< 1000 m,
* oral consent.

Exclusion Criteria

* intercurrent pathology limiting the walking distance (arteriopathy, cardio-respiratory insufficiency, disabling arthrosis affecting the lower limbs...),
* history of spinal surgery for lumbar spinal stenosis,
* extended lumbar arthrodesis (equal to or greater than 2 levels),
* monosegmental and degenerative spondylolisthesis,
* foraminal stenosis,
* motor deficit of the lower limbs or Cauda equina syndrome ("Cauda equina" syndrome (CES) is a serious neurologic condition in which damage to the cauda equina causes acute loss of function of the lumbar plexus, (nerve roots) of the spinal canal below the termination (conus medullaris) of the spinal cord),
* bleeding disorders or allergies contraindicating the epidural infiltration.
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mathieu DE-SÈZE, MD

Role: STUDY_DIRECTOR

service de médecine physique et de réadaptation, Centre Hospitalier Universitaire de Bordeaux,

Antoine BENARD, MD

Role: STUDY_CHAIR

USMR CHU Bordeaux

Locations

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University Hospital of Bordeaux - Hospital Pellegrin

Bordeaux, , France

Site Status

Countries

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France

References

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Berney J. [Epidemiology of narrow spinal canal]. Neurochirurgie. 1994;40(3):174-8. French.

Reference Type BACKGROUND
PMID: 7723924 (View on PubMed)

Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, Birkmeyer NJ, Hilibrand AS, Herkowitz H, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu SS. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007 May 31;356(22):2257-70. doi: 10.1056/NEJMoa070302.

Reference Type BACKGROUND
PMID: 17538085 (View on PubMed)

Yamashita K, Ohzono K, Hiroshima K. Five-year outcomes of surgical treatment for degenerative lumbar spinal stenosis: a prospective observational study of symptom severity at standard intervals after surgery. Spine (Phila Pa 1976). 2006 Jun 1;31(13):1484-90. doi: 10.1097/01.brs.0000219940.26390.26.

Reference Type BACKGROUND
PMID: 16741459 (View on PubMed)

Rillardon L, Guigui P, Veil-Picard A, Slulittel H, Deburge A. [Long-term results of surgical treatment of lumbar spinal stenosis]. Rev Chir Orthop Reparatrice Appar Mot. 2003 Nov;89(7):621-31. French.

Reference Type BACKGROUND
PMID: 14699308 (View on PubMed)

Lieberman I. Surgery reduced pain and disability in lumbar spinal stenosis better than nonoperative treatment. J Bone Joint Surg Am. 2007 Aug;89(8):1872. doi: 10.2106/JBJS.8908.ebo2. No abstract available.

Reference Type BACKGROUND
PMID: 17671033 (View on PubMed)

Other Identifiers

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CHUBX 2012/36

Identifier Type: -

Identifier Source: org_study_id