Endoscopic Electrothermic Procedure of the Sacroiliac Joint (ESIJ)
|ClinicalTrials.gov Identifier: NCT03920345|
Recruitment Status : Terminated (Not enough participation.)
First Posted : April 18, 2019
Last Update Posted : July 19, 2019
- Determine the rate and incidence of peri-operative & post-operative adverse events (complications, infections, re-operations, re-admissions) in the endoscopic approach for the treatment of SIJ arthropathy and chronic lower back pain (CLBP).
- Determine the Health-Related Quality of Life (HRQoL) using EQ-5D scale, VAS (Visual Analog Scale) & ODI (Oswestry Disability Index), outcomes following the endoscopic approach for the treatment of SIJ arthropathy and chronic lower back pain (CLBP) (pre- to post-operative changes).
|Condition or disease||Intervention/treatment||Phase|
|Chronic Lower Back Pain (CLBP) SIJ Arthropathy||Device: MultiZYTE||Not Applicable|
Chronic low back pain (CLBP) that lasts for more than six months is estimated to occur in 60-80% of the general population in their lifetime and is associated with substantial healthcare costs. The sacroiliac joint (SIJ) complex is one of the major sources of CLBP, accounting for around 10-33% of the total number of CLBP cases. The SIJ complex consists of the joint capsule, synovia, various muscles and ligamentous structures overlying the join and neuronal structures that innervate the SIJ. Current interventional and surgical treatment options for SIJ complex mediated CLBP include intraarticular and periarticular injection of the joint, SIJ fusion and radio frequency ablation (RFA) of the neuronal structures innervating the SIJ. The described interventional procedures are simple procedures and provides quick pain relief, but the effect is short-lived. In addition, SIJ fusion is an invasive surgical procedure that should be reserved for refractory intractable pain of the SIJ1.
New endoscopic electrothermic ablation of the SIJ capsula, synovial and neuronal structures have been utilized in the treatment of facetogenic CLBP in a few number of clinical reports with favorable results, but to our knowledge, the efficacy of this technique when applied to SIJ-associated CLBP has not been reported. In this study, the investigators will utilize endoscopy for the precise microsurgical and ablation (ESIJ) of the potential pain generators associated with the SIJ and evaluate the clinical efficacy of this new technique.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||5 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||A prospective, non-randomized, multi-center study, case series, clinical observation study of minimally invasive surgery for the treatment of SIJ arthropathy and chronic lower back pain (CLBP).|
|Masking:||None (Open Label)|
|Official Title:||Endoscopic Electrothermic Procedure of the Sacroiliac Joint|
|Actual Study Start Date :||June 8, 2018|
|Actual Primary Completion Date :||May 16, 2019|
|Actual Study Completion Date :||May 16, 2019|
Experimental: Treatment: Endoscopic ET on SI joint
New techniques have been developed and tested to expand the usefulness of minimally invasive spine surgery beyond disk herniation. This includes endoscopic electrothermic ablation which can be used to target SIJ-associated CLBP. A small retrospective study demonstrated significant improvements in Visual Analog Scale and Oswestry Disability Index from pre-operative levels in patients with CLBP associated with the SIJ for up to 21 months following the procedure. However, there has not yet been a prospective study to assess the efficacy of this procedure, and therefore, this is the aim of this study.
Subjects can be treated either unilateral or bilateral, depending on their condition and the recommended treatment by the surgeon. The decision is a clinical one and is not influenced by the decision of whether to be included in the study or the subsequent outcomes and QoL analysis.
- Change in EQ-5D-3L [ Time Frame: Pre-Op, Peri-Op, 6-weeks, 3-months, 6-months, 12-months, 24-months post-op ]
5 Question Health Questionnaire: patient's rate their mobility, self-care, usual activities, pain/discomfort and anxiety/depression developed by Euroqol Research Foundation.
Each of the 5 dimensions comprising the EQ-5D descriptive system is divided into 5 levels of perceived problems:
Dimension 1: Mobility Dimension 2: Self-Care Dimension 3: Usual Activities Dimension 4: Pain/Discomfort Dimension 5: Anxiety/Depression
Level 1: indicating no problem Level 2: indicating slight problems Level 3: indicating moderate problems Level 4: indicating severe problems Level 5: indicating extreme problems
A total of 3,125 possible health states is defined in this way. Each state is referred to in terms of a 5 digit code.
Lowest Score: 11111 (No problems on any of the 5 dimensions) Highest Score: 55555 (Extreme problems on all of the 5 dimensions)
- Change in Visual Analogue Scale (VAS) [ Time Frame: Pre-Op, Peri-Op, 6-weeks, 3-months, 6-months, 12-months, 24-months post-op ]
Health Questionnaire: patient's rate their health state on a scale from 0 to 100.
Score Range: 0-100mm
Low Score = Lower Pain Intensity High Score = Greater Pain Intensity
- Change in Oswestry Disability Index (ODI) [ Time Frame: Pre-Op, Peri-Op, 6-weeks, 3-months, 6-months, 12-months, 24-months post-op ]
10 Question Health Questionnaire where patient's rate their level of back pain.
Score Range: 0-100%
Low Score = Minimal Disability High Score = Severe Disability
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03920345
|United States, Arizona|
|Dr. Azmi Nasser|
|Mesa, Arizona, United States, 85206|
|United States, Minnesota|
|Dr. Daniel Hanson|
|Maple Grove, Minnesota, United States, 55369|
|Dr. Louis Saeger|
|Minneapolis, Minnesota, United States, 55407|
|Principal Investigator:||Hope Donovan||MileStone Research Organization|