Comparative Study Between Lumbar Foraminal Stenosis Treatment Modalities

NCT ID: NCT06686407

Last Updated: 2024-11-13

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-30

Study Completion Date

2026-10-31

Brief Summary

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The goal of this clinical trial is to compare the clinical and radiological outcome of two different interventional techniques in lumbar foraminal stenosis decompression. The main questions it aims to answer are:

Does minimally invasive techniques give better results than conventional techniques?

Participants will:

Undergo minimally invasive intervention using unilateral biportal endoscopy for lumbar foraminal stenosis decompression Undergo lumbar fusion for lumbar foraminal stenosis decompression Keep a diary of their symptoms and improvement of these symptoms

Detailed Description

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Lumbar foraminal stenosis decompression will be done using two different techniques:

1. Conventional Open Lumbar fusion By laminectomy and facetectomy and fixation with screws and rods ± interbody cage
2. Minimally invasive (Unilateral Biportal Endoscopy) Basic spine surgery instruments, 0° and 30° angled 4-mm diameter endoscopes commonly used in joint arthroscopic surgery, a radiofrequency catheter, Arthroscopic burr, and a shaver.

Surgical approach to the foraminal area Two portals are created to perform this surgery. Water is infused through the endoscope through the viewing portal, and the working portal had an additional purpose as a portal for water outflow. The proximal and distal portals are created 2 cm lateral from the pedicle level on the C-arm anteroposterior image. Each incision for the portals is 0.8 cm in length, which is adequate for instrument and endoscope insertion. For the left side foramen, the proximal and distal portals are used as the viewing and working portals, respectively, and vice versa for the right foramen. After the endoscope insertion through the viewing portal, we secure a space for the lower transverse process around the lateral surface of the facet joint. A radiofrequency catheter or a shaver is used to secure the space, and a radiofrequency catheter is used to control active bleeding.

Decompression of foraminal stenosis After a sufficient working space is obtained, the cranial 50% of the superior articular process of the thickened facet joint is removed using an arthroscopic burr or an osteotome. After removing the superior articular process, the ligamentum flavum around the foramen is removed using a curette and a Kerrison punch. After completion of flavectomy, nerve root and epidural fat are identified. If herniated disc material is found preoperatively, additional discectomy is performed usually from the axilla of the root. Surgery is confirmed to be completed after achieving an amount of free space concordant with the diameter of the nerve root in the foraminal zone, and then a drain tube is inserted.

Conditions

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Lumbar Foraminal Stenosis

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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Group 1

Group Type EXPERIMENTAL

Open lumbar decompression ± fusion

Intervention Type PROCEDURE

Open lumbar decompression by laminectomy and transpedicular screw fixation using screws and rods ± interbody cage "device"

Group 2

Group Type EXPERIMENTAL

Minimally invasive lumbar foraminal decompression using unilateral biportal endoscopy "device"

Intervention Type PROCEDURE

A new endoscopic technique that uses a Unilater Biportal Endoscopy for lumbar foraminal decompression

Interventions

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Open lumbar decompression ± fusion

Open lumbar decompression by laminectomy and transpedicular screw fixation using screws and rods ± interbody cage "device"

Intervention Type PROCEDURE

Minimally invasive lumbar foraminal decompression using unilateral biportal endoscopy "device"

A new endoscopic technique that uses a Unilater Biportal Endoscopy for lumbar foraminal decompression

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All Patients with degenerative lumbar foraminal stenosis, diagnosed in outpatient clinic.
* Patients (age \>18 )

Exclusion Criteria

* Deformity.
* Infection of vertebrae.
* Tumor of vertebrae.
* Instability.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Alaa Eldeen Mohamed Oreaby Adam

Assistant Lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wael Mohamed Ali, Assistant Professor

Role: STUDY_DIRECTOR

Assiut University

Ahmed Hussein Mohamed, Lecturer

Role: STUDY_DIRECTOR

Cairo University

Central Contacts

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Alaa Eldeen Mohamed Adam, Assistant lecturer

Role: CONTACT

+)201008798181

Radwan Nouby, Professor

Role: CONTACT

+0201224480595

References

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Kunogi J, Hasue M. Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine (Phila Pa 1976). 1991 Nov;16(11):1312-20. doi: 10.1097/00007632-199111000-00012.

Reference Type BACKGROUND
PMID: 1750006 (View on PubMed)

Lee S, Lee JW, Yeom JS, Kim KJ, Kim HJ, Chung SK, Kang HS. A practical MRI grading system for lumbar foraminal stenosis. AJR Am J Roentgenol. 2010 Apr;194(4):1095-8. doi: 10.2214/AJR.09.2772.

Reference Type BACKGROUND
PMID: 20308517 (View on PubMed)

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.

Reference Type BACKGROUND
PMID: 17695343 (View on PubMed)

Soliman HM. Irrigation endoscopic decompressive laminotomy. A new endoscopic approach for spinal stenosis decompression. Spine J. 2015 Oct 1;15(10):2282-9. doi: 10.1016/j.spinee.2015.07.009. Epub 2015 Jul 10.

Reference Type BACKGROUND
PMID: 26165475 (View on PubMed)

Hwa Eum J, Hwa Heo D, Son SK, Park CK. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016 Apr;24(4):602-7. doi: 10.3171/2015.7.SPINE15304. Epub 2016 Jan 1.

Reference Type BACKGROUND
PMID: 26722954 (View on PubMed)

Choi DJ, Jung JT, Lee SJ, Kim YS, Jang HJ, Yoo B. Biportal Endoscopic Spinal Surgery for Recurrent Lumbar Disc Herniations. Clin Orthop Surg. 2016 Sep;8(3):325-9. doi: 10.4055/cios.2016.8.3.325. Epub 2016 Aug 10.

Reference Type BACKGROUND
PMID: 27583117 (View on PubMed)

Storzer B, Schnake KJ. Microscopic bilateral decompression by unilateral approach in spinal stenosis. Eur Spine J. 2016 Aug;25 Suppl 2:270-1. doi: 10.1007/s00586-016-4479-3. No abstract available.

Reference Type BACKGROUND
PMID: 26931328 (View on PubMed)

Poletti CE. Central lumbar stenosis caused by ligamentum flavum: unilateral laminotomy for bilateral ligamentectomy: preliminary report of two cases. Neurosurgery. 1995 Aug;37(2):343-7. doi: 10.1227/00006123-199508000-00025.

Reference Type BACKGROUND
PMID: 7477792 (View on PubMed)

Bresnahan LE, Smith JS, Ogden AT, Quinn S, Cybulski GR, Simonian N, Natarajan RN, Fessler RD, Fessler RG. Assessment of Paraspinal Muscle Cross-sectional Area After Lumbar Decompression: Minimally Invasive Versus Open Approaches. Clin Spine Surg. 2017 Apr;30(3):E162-E168. doi: 10.1097/BSD.0000000000000038.

Reference Type BACKGROUND
PMID: 28323694 (View on PubMed)

Guha D, Heary RF, Shamji MF. Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurg Focus. 2015 Oct;39(4):E9. doi: 10.3171/2015.7.FOCUS15259.

Reference Type BACKGROUND
PMID: 26424349 (View on PubMed)

Kim HJ, Jeong JH, Cho HG, Chang BS, Lee CK, Yeom JS. Comparative observational study of surgical outcomes of lumbar foraminal stenosis using minimally invasive microsurgical extraforaminal decompression alone versus posterior lumbar interbody fusion: a prospective cohort study. Eur Spine J. 2015 Feb;24(2):388-95. doi: 10.1007/s00586-014-3592-4. Epub 2014 Sep 25.

Reference Type BACKGROUND
PMID: 25253301 (View on PubMed)

Hallett A, Huntley JS, Gibson JN. Foraminal stenosis and single-level degenerative disc disease: a randomized controlled trial comparing decompression with decompression and instrumented fusion. Spine (Phila Pa 1976). 2007 Jun 1;32(13):1375-80. doi: 10.1097/BRS.0b013e318064520f.

Reference Type BACKGROUND
PMID: 17545903 (View on PubMed)

Chang SB, Lee SH, Ahn Y, Kim JM. Risk factor for unsatisfactory outcome after lumbar foraminal and far lateral microdecompression. Spine (Phila Pa 1976). 2006 May 1;31(10):1163-7. doi: 10.1097/01.brs.0000216431.69359.91.

Reference Type BACKGROUND
PMID: 16648754 (View on PubMed)

Kovacs FM, Urrutia G, Alarcon JD. Surgery versus conservative treatment for symptomatic lumbar spinal stenosis: a systematic review of randomized controlled trials. Spine (Phila Pa 1976). 2011 Sep 15;36(20):E1335-51. doi: 10.1097/BRS.0b013e31820c97b1.

Reference Type BACKGROUND
PMID: 21311394 (View on PubMed)

Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H; SPORT Investigators. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008 Feb 21;358(8):794-810. doi: 10.1056/NEJMoa0707136.

Reference Type BACKGROUND
PMID: 18287602 (View on PubMed)

Ahmad S, Hamad A, Bhalla A, Turner S, Balain B, Jaffray D. The outcome of decompression alone for lumbar spinal stenosis with degenerative spondylolisthesis. Eur Spine J. 2017 Feb;26(2):414-419. doi: 10.1007/s00586-016-4637-7. Epub 2016 Jun 7.

Reference Type BACKGROUND
PMID: 27272494 (View on PubMed)

Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016 Jan 4;352:h6234. doi: 10.1136/bmj.h6234.

Reference Type BACKGROUND
PMID: 26727925 (View on PubMed)

Shenouda EF, Gill SS. Laminal fenestration for the treatment of lumbar nerve root foraminal stenosis. Br J Neurosurg. 2002 Oct;16(5):494-6; discussion 497. doi: 10.1080/0268869021000030320.

Reference Type BACKGROUND
PMID: 12498495 (View on PubMed)

Ahn Y, Oh HK, Kim H, Lee SH, Lee HN. Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery. 2014 Aug;75(2):124-33; discussion 132-3. doi: 10.1227/NEU.0000000000000361.

Reference Type BACKGROUND
PMID: 24691470 (View on PubMed)

Jenis LG, An HS. Spine update. Lumbar foraminal stenosis. Spine (Phila Pa 1976). 2000 Feb 1;25(3):389-94. doi: 10.1097/00007632-200002010-00022.

Reference Type BACKGROUND
PMID: 10703115 (View on PubMed)

Other Identifiers

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Lumbar Foraminal Stenosis

Identifier Type: -

Identifier Source: org_study_id

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