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Procedure

Radiofrequency Neurotomy Techniques for Neck Pain (EndPaRL Trial)

N/A
Recruiting
Led By Anuj Bhatia, MD, PhD
Research Sponsored by University Health Network, Toronto
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Predominant axial (non-radicular) neck pain for at least 3 months
7-day average NRS score for neck pain ≥ 5/10 at baseline evaluation
Must not have
Chronic widespread pain
Systemic or local infection at the time of screening
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 1 week before the procedure and 1 month after the procedure
Awards & highlights
No Placebo-Only Group

Summary

This trial is testing two types of needles for a heat-based treatment to relieve severe neck pain in patients with arthritis in specific neck joints. The treatment works by using heat to stop nerves from sending pain signals.

Who is the study for?
This trial is for adults aged 18-85 with chronic neck pain due to facet joint arthritis, who haven't found relief from standard treatments. They must have had a positive response to diagnostic nerve blocks and moderate functional impairment. Those with widespread pain, prior similar treatments, severe mental health issues, or conditions preventing fluoroscopy use like pregnancy can't join.
What is being tested?
The study compares two radiofrequency neurotomy techniques on nerves in the neck for treating chronic neck pain: one using a straight needle (parallel lesioning) and another using a trident needle (end-on lesioning). The goal is to see which method is more effective at reducing pain.
What are the potential side effects?
Potential side effects of the procedures may include temporary increased neck pain, numbness or tingling in the treated area, minor bleeding or bruising at the injection site, and less commonly infection or allergic reaction to anesthetics used.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I have had mainly neck pain, not shooting pain, for over 3 months.
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My average neck pain score is 5 or more out of 10.
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My pain causes significant difficulty in my daily activities.
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My neck X-ray shows severe arthritis in the spine joints.
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My condition hasn't improved after 3 months of medication and physical therapy.
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I responded well to two nerve block tests with anesthesia.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I experience pain in many parts of my body.
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I do not have any infections.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~1 week before the procedure and 1 month after the procedure
This trial's timeline: 3 weeks for screening, Varies for treatment, and 1 week before the procedure and 1 month after the procedure for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Difference in mean Numerical Rating Scale (NRS) for pain scores
Secondary study objectives
Difference in average physical activity and sleep duration
Difference in incidence of peri-procedural complications and post-procedural adverse effects following the RFN procedure
Difference in mean European Quality of Life (EQ-5D-5L score), a self-assessed, health related, quality of life questionnaire. It ranges from 5 to 25, where higher scores indicate worse outcome.
+11 more

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups
Experimental Treatment
Active Control
Group I: RFN of CMBNn with end-on lesioning with multitIned trident cannulaeExperimental Treatment1 Intervention
Intervention type: RF nerve end-on lesioning at 80-850 Celsius for 90 seconds Intervention name: End-on placement of the multitined trident cannulae Intervention description: Patient in lateral position, targeting joint position between the inferior C2 and superior C3 facets, the middle of the facet pillars for the third to fifth cervical levels, and the superior part of the sixth and seventh cervical facets
Group II: RFN of CMBNn with parallel lesioning with sharp straight conventional cannulae (SIS's technique)Active Control1 Intervention
Intervention type: RF nerve parallel lesioning at 80-850 Celsius for 90 seconds Intervention name: Straight sharp conventional (SIS's technique) Intervention description: Technique as described in the SIS Practice Guidelines for parallel lesioning cannulae placement

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.
Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
The most common treatments for neck pain, such as ganglionectomy, conventional radiofrequency treatment, and pulsed radiofrequency treatment, primarily work by disrupting pain signals. Ganglionectomy involves the surgical removal of a ganglion to prevent pain transmission. Conventional radiofrequency treatment uses heat generated by radio waves to create a lesion on the nerve, thereby interrupting pain signals. Pulsed radiofrequency treatment, on the other hand, delivers short bursts of radiofrequency energy to modulate nerve function without causing significant tissue damage. These treatments are crucial for neck pain patients as they target the source of pain directly, offering potential relief when other methods are ineffective.
A systematic review: current and future directions of dorsal root ganglion therapeutics to treat chronic pain.

Find a Location

Who is running the clinical trial?

University Health Network, TorontoLead Sponsor
1,531 Previous Clinical Trials
504,250 Total Patients Enrolled
Anuj Bhatia, MD, PhDPrincipal InvestigatorDepartment of Anesthesia and Pain Management, University Health Network, Toronto

Media Library

Radiofrequency neurotomy (RFN) of Cervical Medial Branch Nerves (CMBNn) with end-on lesioning with multitined trident cannulae (Procedure) Clinical Trial Eligibility Overview. Trial Name: NCT05818774 — N/A
Neck Pain Research Study Groups: RFN of CMBNn with end-on lesioning with multitIned trident cannulae, RFN of CMBNn with parallel lesioning with sharp straight conventional cannulae (SIS's technique)
Neck Pain Clinical Trial 2023: Radiofrequency neurotomy (RFN) of Cervical Medial Branch Nerves (CMBNn) with end-on lesioning with multitined trident cannulae Highlights & Side Effects. Trial Name: NCT05818774 — N/A
Radiofrequency neurotomy (RFN) of Cervical Medial Branch Nerves (CMBNn) with end-on lesioning with multitined trident cannulae (Procedure) 2023 Treatment Timeline for Medical Study. Trial Name: NCT05818774 — N/A
~38 spots leftby Dec 2026