Double Arm Pivotal Study to Evaluate the Neurolyser XR for the Treatment of Chronic Low Back Pain
Primary Purpose
Facet Syndrome of Lumbar Spine
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Non-Invasive Thermal Ablation of the Medial Branch Nerves (Neurolyser XR)
Sham procedure
Sponsored by
About this trial
This is an interventional treatment trial for Facet Syndrome of Lumbar Spine focused on measuring chronic low back pain, zygapophyseal joint syndrome, Facet syndrome
Eligibility Criteria
Inclusion Criteria:
- Age 50 to 85 years old, legally able and willing to participate in the study and all follow-up visits
- Able and willing to complete the research questionnaires and to communicate with investigator and research team
- Individual with current bilateral or unilateral low back pain of > 6 months duration
- Individual whose back pain is alleviated by recumbency or comfortable sitting position
- Individual presenting with a) a positive (>80% pain relief) to a previous, double, lumbar medial branch block (within the last 12 months) and/or b) with a positive (>70% pain relief lasting more than 6 months) to the most recent lumbar facet thermal radiofrequency denervation
- Average low back pain score of 6 or higher in the last month (on 0-10 scale) with activity
Exclusion Criteria:
- Individuals who are pregnant or breastfeeding
- Individuals younger than 50 or older than 85 years
- BMI greater than 40, or individuals with at least one of the planned targets outside the Neurolyser XR treatment envelope as seen on treatment day on a lateral X-ray scan taken before the treatment.
- Individuals presenting with neurological deficits (including lumbosacral radiculopathy but not solitary radicular pain)
- Individuals with history of lumbar or lumbosacral spine surgery
- Individuals who have had lumbar radiofrequency neurotomy in the past 6 months
- Individuals with history of lumbar spine pathology that may increase procedural risk and/or influence symptoms and/or generate unrelated adverse event (per investigator's discretion)
- Individuals presenting with any severe medical condition preventing them from participation (per investigator's discretion) (Example: inability to lay prone)
- Individuals with extensive scarring of the skin and tissue overlying the treatment area
- Individuals enrolled in or planned to be enrolled in another clinical trial during the duration of this research project
- Any Individuals with an uncontrolled coagulopathy
- Individuals with known osteoporosis with absolute risk of spinal fracture of > 10% over 10 years
- Any Individuals with a history of malignant disease in the past five years or any individuals with clinical history suggestive of new/previously unknown malignancy and pathological pain who require further work up or is currently undergoing work up
- Individuals with rheumatologic diseases causing spine pain that are currently receiving active treatment including steroids, disease modifying drugs, biological agents or immunosuppressants
- Individuals known for concomitant psychiatric disorders, excluding compensated mood disorders
- Individuals with first-degree family member already enrolled in this study
- Individual who is scheduled for any interventional/surgical procedure within 6 months from the treatment date excluding trivial surgeries (e.g., cataract, carpal tunnel release)
- Individuals diagnosed with co-morbid multifocal chronic pain (e.g. fibromyalgia, generalized osteoarthritis)
- Individuals with other chronic pain that is 2 or more points higher on the NRS score than the participants low back pain
- Individuals who have had a steroid injection within the last 2 months from date of enrollment at the location of the planned treatment
- Any individuals with clinical or radiographic evidence of dynamic instability of the lumbar spine
Sites / Locations
- Stamford Hospital
- Mayo University Jacksonville
- Univ of Miami Rehabilitation Medicine
- Emory
- The Physicians Spine and Rehabilitation Specialist of GA
- Charlie Norwood VA Medical Center
- Ainsworth Institute of Pain Management
- Center for Clinical Research
- University of Virginia Pain Management Center
- Gershon Pain Specialists
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Sham Comparator
Arm Label
Thermal ablation of the medial nerve branch using High Intensity Focused Ultrasound
Sham treatment
Arm Description
Non-Invasive Thermal Ablation of the Medial Branch Nerves using the Neurolyser XR High Intensity Focused Ultrasound device
The procedure would be done in an identical manner to the NeurolyserXR treatment without any person in the procedure room knowing that this is a sham procedure. The only difference is that the acoustic energy would not be output from the system during a sham procedure.
Outcomes
Primary Outcome Measures
NRS
Change in average pain score as measured by a numeric rating scale from 0 (no pain) to 10, worst possible pain
Procedure and Device Safety up to six months post procedure
Safety will be measured by the incidence and severity of treatment related adverse events
Secondary Outcome Measures
Oswestry Disability Index (ODI)
Low Back Pain Questionnaire (Range: 0% to 100%)
Patient Global Impression of Change (PGIC)
Patient Global Impression of Change (Range: 1 to 7)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05154448
Brief Title
Double Arm Pivotal Study to Evaluate the Neurolyser XR for the Treatment of Chronic Low Back Pain
Official Title
High-Intensity Focused Ultrasound Ablation With the Neurolyser XR Device for the Treatment of Chronic Low Back Pain: a Prospective Randomized Double-Blind Sham-Controlled Multicenter Study
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 16, 2022 (Actual)
Primary Completion Date
April 1, 2024 (Anticipated)
Study Completion Date
April 1, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
FUSMobile Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Double arm pivotal study to evaluate the Neurolyser XR as a non-invasive treatment of axial chronic low back pain
Detailed Description
Study design: Prospective, Double Arm Timeline: Twelve months enrollment period and 6 months follow-up period. Sites: The study will be conducted at 10 sites in the USA Study population: 80 adult subjects diagnosed with facet related low back pain with an additional 10 roll in subjects.
Arms: 40 patients would be treated by the NeurolyserXR and 40 would get a sham treatment Crossover: blinded crossover between the two arms could be done between 1 and 3 months Primary study objective: Safety and efficacy of the Neurolyser XR for the treatment of chronic low back pain secondary to zygapophyseal joint syndrome.
Safety is measured by the incidence and severity of treatment related adverse events.
Efficacy is measured by pain numerical rating scale
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Facet Syndrome of Lumbar Spine
Keywords
chronic low back pain, zygapophyseal joint syndrome, Facet syndrome
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Double arm randomized study
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The sham procedure would be done using the same system and setup. Randomization would be done using an EDC system and no person at the room would know if the procedure is a treat or sham procedure.
Allocation
Randomized
Enrollment
90 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Thermal ablation of the medial nerve branch using High Intensity Focused Ultrasound
Arm Type
Experimental
Arm Description
Non-Invasive Thermal Ablation of the Medial Branch Nerves using the Neurolyser XR High Intensity Focused Ultrasound device
Arm Title
Sham treatment
Arm Type
Sham Comparator
Arm Description
The procedure would be done in an identical manner to the NeurolyserXR treatment without any person in the procedure room knowing that this is a sham procedure.
The only difference is that the acoustic energy would not be output from the system during a sham procedure.
Intervention Type
Device
Intervention Name(s)
Non-Invasive Thermal Ablation of the Medial Branch Nerves (Neurolyser XR)
Intervention Description
Thermal ablation of the medial nerve branch using High Intensity Focused Ultrasound
Intervention Type
Other
Intervention Name(s)
Sham procedure
Intervention Description
Sham procedure done in an identical manner to the treatment arm, but without deploying acoustical energy
Primary Outcome Measure Information:
Title
NRS
Description
Change in average pain score as measured by a numeric rating scale from 0 (no pain) to 10, worst possible pain
Time Frame
Base line, 2 days 1, 2 & 4 weeks, 3 & 6 months after procedure
Title
Procedure and Device Safety up to six months post procedure
Description
Safety will be measured by the incidence and severity of treatment related adverse events
Time Frame
6 months after procedure
Secondary Outcome Measure Information:
Title
Oswestry Disability Index (ODI)
Description
Low Back Pain Questionnaire (Range: 0% to 100%)
Time Frame
Time Frame: Base line, 1, & 4 weeks, 3 & 6 months after procedure
Title
Patient Global Impression of Change (PGIC)
Description
Patient Global Impression of Change (Range: 1 to 7)
Time Frame
Time Frame: Base line, 1, & 4 weeks, 3 & 6 months after procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 50 to 85 years old, legally able and willing to participate in the study and all follow-up visits
Able and willing to complete the research questionnaires and to communicate with investigator and research team
Individual with current bilateral or unilateral low back pain of > 6 months duration
Individual whose back pain is alleviated by recumbency or comfortable sitting position
Individual presenting with a) a positive (>80% pain relief) to a previous, double, lumbar medial branch block (within the last 12 months) and/or b) with a positive (>70% pain relief lasting more than 6 months) to the most recent lumbar facet thermal radiofrequency denervation
Average low back pain score of 6 or higher in the last month (on 0-10 scale) with activity
Exclusion Criteria:
Individuals who are pregnant or breastfeeding
Individuals younger than 50 or older than 85 years
BMI greater than 40, or individuals with at least one of the planned targets outside the Neurolyser XR treatment envelope as seen on treatment day on a lateral X-ray scan taken before the treatment.
Individuals presenting with neurological deficits (including lumbosacral radiculopathy but not solitary radicular pain)
Individuals with history of lumbar or lumbosacral spine surgery
Individuals who have had lumbar radiofrequency neurotomy in the past 6 months
Individuals with history of lumbar spine pathology that may increase procedural risk and/or influence symptoms and/or generate unrelated adverse event (per investigator's discretion)
Individuals presenting with any severe medical condition preventing them from participation (per investigator's discretion) (Example: inability to lay prone)
Individuals with extensive scarring of the skin and tissue overlying the treatment area
Individuals enrolled in or planned to be enrolled in another clinical trial during the duration of this research project
Any Individuals with an uncontrolled coagulopathy
Individuals with known osteoporosis with absolute risk of spinal fracture of > 10% over 10 years
Any Individuals with a history of malignant disease in the past five years or any individuals with clinical history suggestive of new/previously unknown malignancy and pathological pain who require further work up or is currently undergoing work up
Individuals with rheumatologic diseases causing spine pain that are currently receiving active treatment including steroids, disease modifying drugs, biological agents or immunosuppressants
Individuals known for concomitant psychiatric disorders, excluding compensated mood disorders
Individuals with first-degree family member already enrolled in this study
Individual who is scheduled for any interventional/surgical procedure within 6 months from the treatment date excluding trivial surgeries (e.g., cataract, carpal tunnel release)
Individuals diagnosed with co-morbid multifocal chronic pain (e.g. fibromyalgia, generalized osteoarthritis)
Individuals with other chronic pain that is 2 or more points higher on the NRS score than the participants low back pain
Individuals who have had a steroid injection within the last 2 months from date of enrollment at the location of the planned treatment
Any individuals with clinical or radiographic evidence of dynamic instability of the lumbar spine
Facility Information:
Facility Name
Stamford Hospital
City
Stamford
State/Province
Connecticut
ZIP/Postal Code
06902
Country
United States
Facility Name
Mayo University Jacksonville
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Univ of Miami Rehabilitation Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Emory
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
The Physicians Spine and Rehabilitation Specialist of GA
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30328
Country
United States
Facility Name
Charlie Norwood VA Medical Center
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30904
Country
United States
Facility Name
Ainsworth Institute of Pain Management
City
New York
State/Province
New York
ZIP/Postal Code
10022
Country
United States
Facility Name
Center for Clinical Research
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
University of Virginia Pain Management Center
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22904
Country
United States
Facility Name
Gershon Pain Specialists
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23454
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Double Arm Pivotal Study to Evaluate the Neurolyser XR for the Treatment of Chronic Low Back Pain
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