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Trial registered on ANZCTR
Registration number
ACTRN12608000401358
Ethics application status
Approved
Date submitted
10/07/2008
Date registered
12/08/2008
Date last updated
12/08/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomised controlled trial of transforaminal injections for sciatica
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Scientific title
Randomised controlled trial of transforaminal injections for the relief of lumbar radicular pain caused by lumbar disc herniation
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
lower limb pain caused by lumbar disc herniation
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Condition category
Condition code
Musculoskeletal
3539
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients are randomised by random number allocation to one of five treatment groups. Each receives an injection under fluoroscopic guidance. In three groups the needle is placed in the intervertebral foramen that lodges the affected nerve. Respectively those groups are randomly injected with (1) 0.75ml of a local anaesthetic (0.5% bupivacaine) followed by a steroid preparation (1.75 ml triamcinolone 40mg/ml) or (2) 2ml bupivacaine 0.5% or (3) 2ml normal saline. In two other groups the needle is placed deeply in the back muscles opposite the segment affected by the disc herniation. They receive either 1.75 ml triamcinolone 40mg/ml or 2 ml normal saline. All patients receive at least one therapeutic injection, but are entitled to have one or two repeats of the allocated agent if their response is favourable but partial, and they wish to boost their response.
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
There are no explicit control groups. Each of the tratments to which patients might be allocated has been regarded as effective. EVen intramuscular normal saline is purported to be effective in 48% of patients. The intervention for which there is no quantiative data is transforaminal injection of normal saline, also known as "washout". Of all the interventions, this most closely approximates a control group or placebo.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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relief of radicular pain. as measured by a numerical pain rating scale, and quantified as percentage relief of pain.
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Assessment method [1]
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Timepoint [1]
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1 month, 3 months, 6 months, 12 months
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Secondary outcome [1]
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restoration of function, as measured by (1) restoration of Patient Specified Functional Outcomes, (2) SF-36, and (AQoL).
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Assessment method [1]
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Timepoint [1]
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1 month, 3 months, 6 months, 12 months
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Eligibility
Key inclusion criteria
radicular pain and disc herniation demonstrated on computerised tomography (CT) or magnetic resonance imaging (MRI)
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Minimum age
18
Years
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Maximum age
N/A
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
anatomical barriers to safe executaion of injection, preganancy, allergy to local anaesthetic or contrast medium
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Potential patients identified by Neurosurgeons. Research team confirms eligibility. Patient consents. Treatment allocated by random numbers on day of procedure.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
random numbers table.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/02/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
240
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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International Spine Intervention Society
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Address [1]
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5 Ash Avenue
Kentfield California 94904
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Country [1]
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United States of America
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Primary sponsor type
Individual
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Name
Professor Nikolai Bogduk
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Address
Newcatle Bone and Joint Institute
Royal Newcastle Centre
PO Box 664J Newcastle NSW 2300
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Newcastle Bone and Joint institute
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Address [1]
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Royal Newcastle Centre
PO Box 664J
Newcastle NSW 2300
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Jay Govind
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Address [1]
365
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Pain Management
Canberra Hospital
Woden ACT 2601
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New england Area Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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20/12/2006
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Ethics approval number [1]
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06/12/13/3/01
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Summary
Brief summary
Five different injections are purported to be effective for lumbar radicular pain. Each has its advocates but each lacks convincing scientific data. This study is designed to test which of these injections is effective, for relieving pain and restoring function, in the greatest proportion of patients and for the longest duration.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Professor Nikolai Bogduk
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Address
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PO Box 664J
Newcastle NSW 2300
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Country
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Australia
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Phone
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02 49 223505
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Fax
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02 49 223559
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Nikolai Bogduk
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Address
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PO Box 664J
Newcastle NSW 2300
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Country
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Australia
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Phone
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02 49 223505
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Fax
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02 49 223559
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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