Burst Crossover Trial

NCT ID: NCT05372822

Last Updated: 2024-12-24

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-01

Study Completion Date

2025-08-15

Brief Summary

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Spinal cord stimulation (SCS) is a widely applied therapy to treat chronic neuropathic pain, and one of the most common indications is persisting radicular neuropathic pain following lumbar spine surgery. In traditional SCS therapies, the objective has been to replace the pain sensation with paresthesia. The anticipation is that the electrical current alters pain processing by masking the sensation of pain with a comfortable tingling or paresthesia. Although patients mostly cope with paresthesia, a significant proportion reports that the sensation is unpleasant.

'Burst' SCS utilizes complex programming to deliver high-frequency stimuli. This SCS technique seems to provide paresthesia-free stimulation, resulting in better pain relief of low back and leg pain then traditional tonic stimulation.

The widespread use of SCS has not been backed by solid evidence. The absence of placebo-controlled trials has long been an important point of criticism, but due to the nature of the intervention with sensation of paresthesia, studies with placebo control have so far not been considered possible. When 'burst' SCS is used the stimulation is often unnoticed by the patient, allowing comparison with placebo stimulation.

The aim of this randomized double-blind sham-controlled crossover trial is to evaluate the efficacy of 'burst' spinal cord stimulation for chronic radicular pain following spine surgery.

Detailed Description

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Conditions

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Back Pain with Radiation Pain, Postoperative

Keywords

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Lumbar Vertebrae Surgery Postoperational Complications Spinal Cord Stimulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
During the 12 months following implantation of a spinal cord stimulation (SCS) system, the patients will undergo four three-month long periods with either burst SCS or no stimulation (sham) in a randomized order. All patients will undergo two periods of SCS and sham stimulation.

Study Groups

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Burst SCS

Burst Spinal cord stimulation. SCS system implanted and burst stimulation given

Group Type EXPERIMENTAL

Burst Spinal Cord Stimulation

Intervention Type PROCEDURE

Burst stimulation utilizes complex programming to deliver high-frequency stimuli of a 40 Hz burst mode with 5 spikes at 500 Hz per spike delivered in a constant current mode

Sham spinal cord stimulation

Intervention Type PROCEDURE

No spinal cord stimulation is provided

SCS implant

Intervention Type DEVICE

a subcutaneously implantable pulse generator ("pacemaker") for long-term therapy.

The following system from Abbott will be implanted: ProclaimTM XR implantable pulse generator and Octrode® 8-contact lead

Sham SCS

Sham spinal cord stimulation. SCS system implanted but no stimulation given.

Group Type SHAM_COMPARATOR

Burst Spinal Cord Stimulation

Intervention Type PROCEDURE

Burst stimulation utilizes complex programming to deliver high-frequency stimuli of a 40 Hz burst mode with 5 spikes at 500 Hz per spike delivered in a constant current mode

Sham spinal cord stimulation

Intervention Type PROCEDURE

No spinal cord stimulation is provided

SCS implant

Intervention Type DEVICE

a subcutaneously implantable pulse generator ("pacemaker") for long-term therapy.

The following system from Abbott will be implanted: ProclaimTM XR implantable pulse generator and Octrode® 8-contact lead

Interventions

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Burst Spinal Cord Stimulation

Burst stimulation utilizes complex programming to deliver high-frequency stimuli of a 40 Hz burst mode with 5 spikes at 500 Hz per spike delivered in a constant current mode

Intervention Type PROCEDURE

Sham spinal cord stimulation

No spinal cord stimulation is provided

Intervention Type PROCEDURE

SCS implant

a subcutaneously implantable pulse generator ("pacemaker") for long-term therapy.

The following system from Abbott will be implanted: ProclaimTM XR implantable pulse generator and Octrode® 8-contact lead

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Have undergone ≥1 back surgeries and developed chronic radicular pain that has remained refractory to non-surgical treatment for ≥6 months
* Minimum pain intensity of 5/10 on the leg pain NRS at baseline
* Successful two-week SCS testing period with tonic stimulation (≥2 points reduction in leg pain NRS from baseline). This means patients will experience paresthesia during the SCS trial period
* Mandatory assessment at the Multidisciplinary outpatient clinic for back-, neck- and shoulder rehabilitation, St. Olavs University Hospital
* Successful two-week SCS testing period with tonic stimulation (≥50% reduction in leg pain NRS from baseline). This means patients will experience paresthesia during the SCS trial period

Exclusion Criteria

* Coexisting conditions that would increase procedural risk (e.g., sepsis, coagulopathy)
* History of laminectomy or posterior fusion at the thoracolumbar junction, where percutaneous electrode end tips are routinely placed.
* Abnormal pain behavior and/or unresolved psychiatric illness.
* Unresolved issues of secondary gain or inappropriate medication use.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Norwegian University of Science and Technology

OTHER

Sponsor Role collaborator

St. Olavs Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sasha Gulati, md prof

Role: PRINCIPAL_INVESTIGATOR

St. Olavs Hospital

Geir Bråthen, md prof

Role: STUDY_DIRECTOR

St. Olavs Hospital

Locations

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St Olavs Hospital

Trondheim, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Sasha Gulati, md prof

Role: CONTACT

Phone: +47 73592020

Email: [email protected]

Sven M Carlsen, md prof

Role: CONTACT

Phone: +47 91769528

Email: [email protected]

Facility Contacts

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Sasha Gulati, md phd

Role: primary

Other Identifiers

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2018/475-b

Identifier Type: -

Identifier Source: org_study_id