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Cooled RF Lesion MRI Characteristics

Primary Purpose

Arthritis;Lumbosacral, Osteo Arthritis Knee, Sacroiliitis

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cooled radiofrequency ablation
Sponsored by
International Spine, Pain and Performance Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arthritis;Lumbosacral focused on measuring Cooled radiofrequency ablation, MRI

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age ≥ 21 years
  2. Able to understand the informed consent form and provide written informed consent and able to complete outcome measures.
  3. Must be clinically appropriate candidate to receive CRFA for treatment of chronic pain.
  4. Willing and able to receive an MRI

Exclusion Criteria:

  1. Unable to receive an MRI (i.e. due to pacemaker or iron-based metal implant).
  2. Unable to receive an MRI (i.e. iron-based metal implant).
  3. Extremely thin patients and those with minimal subcutaneous tissue thickness that would not accommodate a radiofrequency lesion of up to 14mm in diameter to limit the risk of skin burns.
  4. Active joint infection or systemic or localized infection at the needle entry site (subject may be considered for inclusion once infection is resolved.)
  5. Subject currently implanted with a pacemaker or defibrillator
  6. In the event a pre-treatment MRI is obtained; trauma or injury occurring to the targeted area between the baseline MRI and CRFA treatment
  7. Subject unwillingness or unable to comply with protocol requirements

Sites / Locations

  • International Spine, and Performance Center
  • International Spine, Pain and Performance Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Cooled radiofrequency ablation

Arm Description

This is a single arm study. Patients who will be undergoing cooled radiofrequency ablation for the treatment of arthritis in the cervical facet joints, thoracic facet joints, lumbar facet joints, sacroiliac (SI) region, hip and knee.

Outcomes

Primary Outcome Measures

Cooled radiofrequency ablation lesion size
Size in millimeters of cooled radiofrequency ablation lesion via MRI

Secondary Outcome Measures

Pain relief
Compare pre-procedure and post-procedure change in pain using the numerical pain rating scale with 0 being no pain and 10 being the worst possible pain.

Full Information

First Posted
March 5, 2018
Last Updated
August 6, 2019
Sponsor
International Spine, Pain and Performance Center
Collaborators
Halyard Health
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1. Study Identification

Unique Protocol Identification Number
NCT03631030
Brief Title
Cooled RF Lesion MRI Characteristics
Official Title
A Prospective, Single-center, Pilot Study of in Vivo Lesion Characteristics Post Coolief Cooled Radiofrequency Denervation as a Treatment for Chronic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Unknown status
Study Start Date
February 25, 2018 (Actual)
Primary Completion Date
January 2020 (Anticipated)
Study Completion Date
January 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International Spine, Pain and Performance Center
Collaborators
Halyard Health

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Prospective, Single-center, Pilot Study will assist in gaining an understanding of the actual CRFA lesions in an in vivo situation in areas where CRFA is utilized as a standard of care treatment option for the relief of chronic pain (cervical facet joints, thoracic facet joints, lumbar facet joints, Sacroiliac (SI) region, hip and knee).
Detailed Description
This study will be a prospective, single-center, pilot study. Adult subjects over the age 21 diagnosed with chronic joint pain (≥ 3 months), scheduled to receive Radiofrequency denervation and meet the selection criteria are eligible to participate in this study. The specific targeted areas of interest in this study will include Cervical facet joints, Thoracic facet joints, Lumbar facet joints, Sacroiliac (SI) region, hip and knee. The treating physician will follow Standard of Care treatment for all enrolled subjects. As illustrated in Figure 1, the study consists of a screening visit, a treatment visit and a follow up visit. All subjects receiving CRFA will receive an MRI 2 - 7 days after the CRFA procedure. Subjects receiving CRFA of the Sacroiliac Joint will also receive an MRI within 30 days prior to the CRFA procedure. The treating physician may also request an MRI be performed prior to the procedure for subjects receiving CRFA of other targeted areas. The point of enrollment for each subject is the time that they sign the Informed Consent Form. MRI data will be reviewed by the radiologist on a per patient basis to confirm lesion characteristics. It is anticipated that 3-5 subjects per level will be needed to fully quantify lesion characteristics, however; enrollment will remain flexible for each targeted area based on real time review of MRI data.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arthritis;Lumbosacral, Osteo Arthritis Knee, Sacroiliitis, Hip Osteoarthritis, Arthritis, Degenerative
Keywords
Cooled radiofrequency ablation, MRI

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Prospective, singe group cohort study
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cooled radiofrequency ablation
Arm Type
Other
Arm Description
This is a single arm study. Patients who will be undergoing cooled radiofrequency ablation for the treatment of arthritis in the cervical facet joints, thoracic facet joints, lumbar facet joints, sacroiliac (SI) region, hip and knee.
Intervention Type
Device
Intervention Name(s)
Cooled radiofrequency ablation
Intervention Description
Cooled Radiofrequency ablation (CRFA) is a well-established method for delivering lesions into nervous tissue to accomplish neurotomy procedures
Primary Outcome Measure Information:
Title
Cooled radiofrequency ablation lesion size
Description
Size in millimeters of cooled radiofrequency ablation lesion via MRI
Time Frame
MRI obtained between 2-7 days post-procedure.
Secondary Outcome Measure Information:
Title
Pain relief
Description
Compare pre-procedure and post-procedure change in pain using the numerical pain rating scale with 0 being no pain and 10 being the worst possible pain.
Time Frame
2-4 weeks post-procedure as compared to pre-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age ≥ 21 years Able to understand the informed consent form and provide written informed consent and able to complete outcome measures. Must be clinically appropriate candidate to receive CRFA for treatment of chronic pain. Willing and able to receive an MRI Exclusion Criteria: Unable to receive an MRI (i.e. due to pacemaker or iron-based metal implant). Unable to receive an MRI (i.e. iron-based metal implant). Extremely thin patients and those with minimal subcutaneous tissue thickness that would not accommodate a radiofrequency lesion of up to 14mm in diameter to limit the risk of skin burns. Active joint infection or systemic or localized infection at the needle entry site (subject may be considered for inclusion once infection is resolved.) Subject currently implanted with a pacemaker or defibrillator In the event a pre-treatment MRI is obtained; trauma or injury occurring to the targeted area between the baseline MRI and CRFA treatment Subject unwillingness or unable to comply with protocol requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mehul Desai, MD, MPH
Organizational Affiliation
International Spine Pain & Performance Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
International Spine, and Performance Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20037
Country
United States
Facility Name
International Spine, Pain and Performance Center
City
Arlington
State/Province
Virginia
ZIP/Postal Code
22205
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20030745
Citation
Kapural L, Stojanovic M, Sessler DI, Bensitel T, Zovkic P. Cooled radiofrequency (RF) of L5 dorsal ramus for RF denervation of the sacroiliac joint: technical report. Pain Med. 2010 Jan;11(1):53-7. doi: 10.1111/j.1526-4637.2009.00772.x. Epub 2009 Dec 16. Erratum In: Pain Med. 2010 Dec;11(12):1874. Sessler, Daniel I [added].
Results Reference
background
PubMed Identifier
22299761
Citation
Patel N, Gross A, Brown L, Gekht G. A randomized, placebo-controlled study to assess the efficacy of lateral branch neurotomy for chronic sacroiliac joint pain. Pain Med. 2012 Mar;13(3):383-98. doi: 10.1111/j.1526-4637.2012.01328.x. Epub 2012 Feb 2.
Results Reference
background
PubMed Identifier
23279364
Citation
Stelzer W, Aiglesberger M, Stelzer D, Stelzer V. Use of cooled radiofrequency lateral branch neurotomy for the treatment of sacroiliac joint-mediated low back pain: a large case series. Pain Med. 2013 Jan;14(1):29-35. doi: 10.1111/pme.12014. Epub 2012 Dec 28.
Results Reference
background
PubMed Identifier
23869175
Citation
Ho KY, Hadi MA, Pasutharnchat K, Tan KH. Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases. J Pain Res. 2013 Jul 4;6:505-11. doi: 10.2147/JPR.S46827. Print 2013.
Results Reference
background
PubMed Identifier
17559482
Citation
Kapural L, Mekhail N. Novel intradiscal biacuplasty (IDB) for the treatment of lumbar discogenic pain. Pain Pract. 2007 Jun;7(2):130-4. doi: 10.1111/j.1533-2500.2007.00120.x.
Results Reference
background
PubMed Identifier
21197258
Citation
Karaman H, Tufek A, Kavak GO, Kaya S, Yildirim ZB, Uysal E, Celik F. 6-month results of TransDiscal Biacuplasty on patients with discogenic low back pain: preliminary findings. Int J Med Sci. 2010 Dec 14;8(1):1-8. doi: 10.7150/ijms.8.1.
Results Reference
background
PubMed Identifier
23279658
Citation
Kapural L, Vrooman B, Sarwar S, Krizanac-Bengez L, Rauck R, Gilmore C, North J, Girgis G, Mekhail N. A randomized, placebo-controlled trial of transdiscal radiofrequency, biacuplasty for treatment of discogenic lower back pain. Pain Med. 2013 Mar;14(3):362-73. doi: 10.1111/pme.12023. Epub 2012 Dec 28.
Results Reference
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Cooled RF Lesion MRI Characteristics

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