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Procedure
Radiofrequency Neurotomy Techniques for Low Back Pain
N/A
Recruiting
Led By Byron Schneider, MD
Research Sponsored by Vanderbilt University Medical Center
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
At least 80% improvement on two consecutive lumbar medial branch blocks of no more than a total of 4 lumbar facet joints
Unilateral or bilateral low back pain of at least 4/10 on Numeric Pain Rating Scale (NPRS) present for at least 2 months that has failed to adequately respond to at least 6 weeks of physical therapy and oral pain medication
Must not have
Medical conditions causing significant functional disability (e.g., stroke, COPD)
Chronic widespread pain or somatoform disorder (e.g. fibromyalgia)
Timeline
Screening 3 weeks
Treatment Varies
Follow Up baseline to 12 months
Awards & highlights
No Placebo-Only Group
Summary
This trial is studying two different types of radiofrequency neurotomy to see which is more effective in treating low back pain caused by the lumbar zygapophyseal joints.
Who is the study for?
This trial is for people over 40 with low back pain that hasn't improved after physical therapy and pain meds. They must have had significant relief from two lumbar medial branch blocks, be able to understand English, consent to treatment, and attend follow-ups. It's not for those with certain conditions like lumbar radiculopathy, litigation or compensation cases related to their pain, severe mental health issues, recent infections or injections in the lower back area.
What is being tested?
The study compares two techniques of radiofrequency neurotomy—a procedure used to reduce chronic low back pain—by using different needle sizes (16 gauge parallel vs. 22 gauge perpendicular) on patients who've responded well to preliminary treatments. The goal is to see which method gives better or longer-lasting pain relief.
What are the potential side effects?
While the description doesn't list specific side effects, procedures involving needles can typically cause temporary discomfort at the injection site, bleeding, infection risk and possibly nerve damage if not performed correctly.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I experienced significant pain relief from two back nerve block procedures.
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I have had lower back pain for 2 months, not better after 6 weeks of physical therapy and pain meds.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
I have a medical condition like stroke or severe lung disease that greatly limits my daily activities.
Select...
I have been diagnosed with chronic widespread pain or a condition like fibromyalgia.
Select...
My BMI is over 40.
Select...
I can attend all required follow-up appointments.
Select...
I am experiencing worsening muscle weakness or signs of nerve issues in my lower back.
Select...
I have an active inflammatory arthritis condition.
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My main issue is sciatica.
Select...
I receive payment for my pain treatment, like disability benefits.
Select...
I have had surgery to join two or more spine bones in my lower back.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ baseline to 12 months
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~baseline to 12 months
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
Change in Modified Clinical Outcome Measurement Brief Instrument (COMBI), Enjoyment
Change in Modified Clinical Outcome Measurement Brief Instrument (COMBI), General Activity
Change in Modified Clinical Outcome Measurement Brief Instrument (COMBI), Global Impression of Change
+5 moreAwards & Highlights
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Trial Design
2Treatment groups
Active Control
Group I: Parallel placement of 16 gauge electrodesActive Control1 Intervention
Parallel Group will undergo radiofrequency ablation via the approach described in Spine Intervention Practice Guidelines via 16 gauge electrodes. Specifically, the target nerve will be targeted with a parallel approach so as the electrode lay parallel to the nerves location within the sulcus formed by the neck of superior articular process and transverse process (or sacral ala for L5) cephalad to the point it is covered by the mamillo-accessory ligament.
Group II: Perpendicular placement with 22 gauge electrodesActive Control1 Intervention
Perpendicular Group will undergo radiofrequency ablation via the approach described in Spine Intervention Society Practice Guidelines for medial branch blocks, using a 22 gauge electrode. Specifically, the target nerve will be targeted with a perpendicular approach so as the tip of electrode contact the nerve at some point of it course along the sulcus formed by the neck of superior articular process and transverse process (or sacral ala for L5) cephalad to the point it is covered by the mamillo-accessory ligament.
Find a Location
Who is running the clinical trial?
Vanderbilt University Medical CenterLead Sponsor
908 Previous Clinical Trials
934,455 Total Patients Enrolled
8 Trials studying Low Back Pain
374 Patients Enrolled for Low Back Pain
Spine Intervention SocietyUNKNOWN
1 Previous Clinical Trials
50 Total Patients Enrolled
1 Trials studying Low Back Pain
50 Patients Enrolled for Low Back Pain
Byron Schneider, MD1.921 ReviewsPrincipal Investigator - Vanderbilt University Medical Center
Vanderbilt University Medical Center
1Patient Review
This doctor was more interested in his own appearance and clothing than in listening to me. He prescribed a medication that has well-known constipating side effects, despite my telling him about my history of bowel problems. He also dismissed my husband's serious back problems as unrelated to his neck condition — which led to my husband nearly becoming paralyzed. Do not see this doctor.
Blake Fechtel, MD MScStudy DirectorVanderbilt University Medical Center
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- You are currently in a legal case related to your pain.I have a medical condition like stroke or severe lung disease that greatly limits my daily activities.The doctor will decide if you need a first medial branch block based on your medical condition.I have been diagnosed with chronic widespread pain or a condition like fibromyalgia.I experienced significant pain relief from two back nerve block procedures.I agree to discuss and decide on my treatment with my doctor.My BMI is over 40.I have had lower back pain for 2 months, not better after 6 weeks of physical therapy and pain meds.You are allergic to contrast dye or local numbing medicine.I have not taken antibiotics for an infection in the last week.You have a history of severe addiction, depression, or psychotic behavior.I have had a steroid injection in my lower back in the last 3 months.I can attend all required follow-up appointments.You might be pregnant or cannot have an X-ray procedure for another reason.I am over 40, understand English, can follow study procedures, and can attend all follow-ups.I am experiencing worsening muscle weakness or signs of nerve issues in my lower back.I have an active inflammatory arthritis condition.My main issue is sciatica.I receive payment for my pain treatment, like disability benefits.I have had surgery to join two or more spine bones in my lower back.
Research Study Groups:
This trial has the following groups:- Group 1: Parallel placement of 16 gauge electrodes
- Group 2: Perpendicular placement with 22 gauge electrodes
Awards:
This trial has 1 awards, including:- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.