MRgFUS and RFA for Treatment of Facet-joint Osteoarthritis Low Back Pain

NCT ID: NCT03168802

Last Updated: 2024-12-05

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

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-24

Study Completion Date

2025-11-25

Brief Summary

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This is a prospective, randomized, two-arm, phase II study.

The purpose of this study is:

* To evaluate and compare the efficacy and safety of magnetic resonance-guided focused ultrasound (MRgFUS) and radiofrequency ablation (RFA) for treatment of facet-joint osteoarthritis low back pain.
* Determining the effect of the MRgFUS System and RFA for improving functional disabilities and in reducing pain resulting from facet-joint osteoarthritis low back pain. Efficacy will be determined by the level of pain relief (as measured by the Numerical Rating Scale, NRS), decrease in analgesics/opiate, improved quality of life (as measured by the Oswestry Disability Questionnaire, ODQ, and core outcome measures index questionnaire, COMI), pain interference with function (as measured by the Brief Pain Inventory-Interference scale, BPI-QoL), general health status (as measured by the EQ5D), physical exam, X-ray and MRI studies from baseline up to 12-Months post- MRgFUS and radiofrequency treatment.
* Evaluate incidence and severity of adverse events associated with the MRgFUS system and RFA used for the treatment of pain resulting from facet-joint osteoarthritis low back pain.

Detailed Description

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Conditions

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Chronic Low Back Pain Facet Joint Syndrome

Keywords

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Focused ultrasound Ablation Radiofrequency Ablation Facet joint syndrome Chronic low back pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

50 patients in each arm.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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MRgFUS facet treatment

MRgFUS ablation for facet joint pain once at Lumbar spine

Group Type EXPERIMENTAL

MRgFUS ablation

Intervention Type PROCEDURE

Focus ultrasound ablation therapy under MRI navigation for facet joint syndrome.

Radiofrequency ablation facet treatment

Radiofrequency ablation for facet joint pain once at Lumbar spine

Group Type ACTIVE_COMPARATOR

Radiofrequency ablation

Intervention Type PROCEDURE

Radiofrequency ablation therapy under C-arm navigation for facet joint syndrome.

Interventions

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MRgFUS ablation

Focus ultrasound ablation therapy under MRI navigation for facet joint syndrome.

Intervention Type PROCEDURE

Radiofrequency ablation

Radiofrequency ablation therapy under C-arm navigation for facet joint syndrome.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Men and women age 20 to 79 years old
2. Suffering from lumbar vertebral facet joint syndrome.
3. Lower back pain at least six months (NRS≄4).
4. Conventional treatment of pain includes NSAIDs, opioids, muscle relaxants, oral steroids, physical therapy or chiropractic therapy.
5. Imaging of the spine have facet osteoarthritis.
6. Referred pain is no more below the knee.
7. At least once when local anesthesia or diagnostic medial nerve branch injection, pain reduction\> 75% (0.5ml of 2% lidocaine).

Exclusion Criteria

1. Patients with evidence of lumbosacral radiculopathy on MRI, CT or physical exam findings, including radicular leg pain.
2. Patients with motor deficit or any other indication for surgical intervention.
3. Patients with MRgFUS or RF treatment for LBP within the last 6 months.
4. Patients with previous low back surgery.
5. Patients who are pregnant.
6. Patients with existing malignancy.
7. Patients with allergies to relevant contrast, anesthetics, sedation drugs.
8. Patients with contraindications for MRI.
9. Patients with an acute medical condition (e.g., pneumonia, sepsis) that is expected to hinder them from completing this study.
10. Patients with unstable cardiac status including:

* Unstable angina pectoris on medication
* Patients with documented myocardial infarction less than 40 days prior to protocol enrolment
* Patients with Severe Congestive Heart Failure, NYHA class 4.
* Patients on anti-arrhythmic drugs or with uncontrolled and/or untreated arrhythmia status
* Patients with pacemaker
11. Patients with severe cerebrovascular disease (CVA within last 6 months)
12. Patients with severe hypertension (diastolic BP \> 100 on medication)
13. Patients with an active infection or severe hematological, neurological, or other uncontrolled disease.
14. Patients unable to communicate with the investigator and staff.
15. Patients who are not able or willing to tolerate the required prolonged stationary position during treatment (approximately 2 hrs.)
16. Coagulation disorders or other bleeding disorders, use of anticoagulants or antiplatelet drugs within 5 days before treatment.
17. When local anesthesia or diagnostic medial nerve branch injection, the pain does not reach 75% (0.5 mL of 2% lidocaine).
Minimum Eligible Age

20 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Taipei Medical University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Meng-Huang Wu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yen Yun, PhD

Role: STUDY_CHAIR

Taipei Medical University

Locations

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Taipei medical university hospital

Taipei, Please Select, Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Meng-Huang Wu, MD

Role: CONTACT

Phone: 227372181

Email: [email protected]

Facility Contacts

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Meng-Huang Wu, MD

Role: primary

References

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Krug R, Do L, Rieke V, Wilson MW, Saeed M. Evaluation of MRI protocols for the assessment of lumbar facet joints after MR-guided focused ultrasound treatment. J Ther Ultrasound. 2016 Apr 6;4:14. doi: 10.1186/s40349-016-0057-8. eCollection 2016.

Reference Type BACKGROUND
PMID: 27054038 (View on PubMed)

Maas ET, Ostelo RW, Niemisto L, Jousimaa J, Hurri H, Malmivaara A, van Tulder MW. Radiofrequency denervation for chronic low back pain. Cochrane Database Syst Rev. 2015 Oct 23;2015(10):CD008572. doi: 10.1002/14651858.CD008572.pub2.

Reference Type BACKGROUND
PMID: 26495910 (View on PubMed)

Weeks EM, Platt MW, Gedroyc W. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain--case series of an innovative new technique. Eur Radiol. 2012 Dec;22(12):2822-35. doi: 10.1007/s00330-012-2628-6. Epub 2012 Aug 31.

Reference Type BACKGROUND
PMID: 22935902 (View on PubMed)

Kaye EA, Monette S, Srimathveeravalli G, Maybody M, Solomon SB, Gulati A. MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model. Int J Hyperthermia. 2016 Nov;32(7):786-94. doi: 10.1080/02656736.2016.1197972. Epub 2016 Jul 21.

Reference Type BACKGROUND
PMID: 27443328 (View on PubMed)

Other Identifiers

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N201609021

Identifier Type: -

Identifier Source: org_study_id