Magnetic Resonance Imaging Study on Young and Middle-aged Patients With Cervical Spondylotic Pain

NCT ID: NCT06217029

Last Updated: 2024-02-26

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

RECRUITING

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-01-06

Study Completion Date

2027-12-31

Brief Summary

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Cervical and shoulder pain in young adults is commonly caused by intervertebral disc degeneration, bulge or herniation. Disc degeneration includes the synthetic and degradative imbalance of myxoid matrix, degeneration of annulus collagen, and decrease of water content in nucleus pulposus. A few patients with cervical degeneration had moderate to severe pain, but there are no obvious abnormalities in the shape and signal of the disc with routine MRI, which may be related to the early discal degeneration. In most cases, the pain could be relieved by non-surgical treatment due to mild decreased proteoglycan and slight abnormality of water diffusion, but these changes cannot be clearly demonstrated by routine MRI. Therefore, it is necessary to rely on sensitive MRI techniques to reflect the abnormal microstructure in the nucleus pulposus and annulus fibrosus, so as to assist the early detection of the main reason in patients with neck and shoulder pain and the evaluation of the efficacy of treatment.

Detailed Description

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This is an observational, longitudinal, and single-center study. Confirmed patients with cervical and shoulder pain will complete several clinical and imaging programs before and after 3 and 12 months of non-surgical treatment for exploring the main reason of the symptom and the imaging predictors of treatment effect in the disease. The collected materials are listed below: (1) 3 times cervical MRI scans, including T2-mapping, T1ρ and DKI sequences, (2) visual analog scale (for pain assessment) and disease duration. Then the T2 value, T1ρ, and DKI derived parameters will be measured in the nucleus pulposus and annulus fibrosus.

Conditions

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Neck Pain

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Effective Group of Cervical Spondylotic Pain

VAS reduction rate is used to evaluate clinical efficacy. The reduction rate = (baseline value - end value)/baseline value. The clinical efficacy is divided into four levels: cured, significant effect, slight effect, ineffective or recurrent. cured: reduction rate ≥ 75%; significant effect: 50% ≤ reduction rate \< 75%; slight effect: 25% ≤ reduction rate \< 50%; ineffective: reduction rate \< 25%. The "cured + significant effect" group was classified as the treatment effective group,

physiotherapy and maxillary traction

Intervention Type OTHER

1. Mobility exercises
2. Ultrasound or electric stimulation
3. Application of equipment, such as braces, slings and taping
4. Registered massage therapy
5. Trigger point and myofascial release

Ineffective Group of Cervical Spondylotic Pain

The "slight effect + ineffective" group and the recurrent group were classified as the treatment ineffective group

physiotherapy and maxillary traction

Intervention Type OTHER

1. Mobility exercises
2. Ultrasound or electric stimulation
3. Application of equipment, such as braces, slings and taping
4. Registered massage therapy
5. Trigger point and myofascial release

Interventions

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physiotherapy and maxillary traction

1. Mobility exercises
2. Ultrasound or electric stimulation
3. Application of equipment, such as braces, slings and taping
4. Registered massage therapy
5. Trigger point and myofascial release

Intervention Type OTHER

Other Intervention Names

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massage therapy

Eligibility Criteria

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Inclusion Criteria

1. Neck and shoulder pain, with or without upper limb pain and numbness;
2. Disease duration longer than 2 months
3. Visual analogue score (VAS) ≥ 3
4. Cervical MRI showing cervical disc degeneration, bulge, protrusion, etc.
5. Patients will undergo non-surgical treatment (maxillary occipital traction, massage, etc.)

Exclusion Criteria

1. Severe trauma and surgery in neck and shoulder region.
2. X-ray or CT showing the severe cervical spine hyperplasia, infection (suppurative, tuberculous), neoplasm (various primary and secondary tumors), rheumatic (rheumatoid arthritis, ankylosing spondylitis), and nuclei pulposus calcification.
3. Cervical MRI revealed organic lesions such as inflammation of the spinal cord, tumors, syringomyelia, etc.
4. Chronic pain in other regions.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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First Affiliated Hospital Xi'an Jiaotong University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ming Zhang, M.D.

Role: STUDY_DIRECTOR

First Affiliated Hospital Xi'an Jiaotong University

Locations

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The First Affiliated Hospital of Xi'an Jiaotong University

Xi'an, Shaanxi, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yuan Wang, M.D.

Role: CONTACT

+8613324598144

Dan Li, M.D.

Role: CONTACT

+8613324598146

Facility Contacts

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Yuan Wang, M.D.

Role: primary

0086-13324598144

Dan Li, M.D.

Role: backup

0086-13324598146

References

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Zhuang L, Wang L, Xu D, Wang Z, Liang R. Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. J Orthop Sci. 2021 Jan;26(1):110-115. doi: 10.1016/j.jos.2020.02.009. Epub 2020 Mar 20.

Reference Type RESULT
PMID: 32205018 (View on PubMed)

Chen C, Huang M, Han Z, Shao L, Xie Y, Wu J, Zhang Y, Xin H, Ren A, Guo Y, Wang D, He Q, Ruan D. Quantitative T2 magnetic resonance imaging compared to morphological grading of the early cervical intervertebral disc degeneration: an evaluation approach in asymptomatic young adults. PLoS One. 2014 Feb 3;9(2):e87856. doi: 10.1371/journal.pone.0087856. eCollection 2014.

Reference Type RESULT
PMID: 24498384 (View on PubMed)

Chen P, Wu C, Huang M, Jin G, Shi Q, Han Z, Chen C. Apparent Diffusion Coefficient of Diffusion-Weighted Imaging in Evaluation of Cervical Intervertebral Disc Degeneration: An Observational Study with 3.0 T Magnetic Resonance Imaging. Biomed Res Int. 2018 Feb 18;2018:6843053. doi: 10.1155/2018/6843053. eCollection 2018.

Reference Type RESULT
PMID: 29670903 (View on PubMed)

Leonova O, Baykov E, Sanginov A, Krutko A. Cervical Disc Degeneration and Vertebral Endplate Defects After the Fused Operation. Spine (Phila Pa 1976). 2021 Sep 15;46(18):1234-1240. doi: 10.1097/BRS.0000000000004007.

Reference Type RESULT
PMID: 33595261 (View on PubMed)

Other Identifiers

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XJTU1AF-CRF-2023-030

Identifier Type: -

Identifier Source: org_study_id

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