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Sciatica Epidural Radiculopathy Experimental New Interventional TherapY Clonidine Micropellet (SERENITY CM)

Primary Purpose

Lumbosacral Radiculopathy

Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Clonidine Micropellets
Tuohy epidural needle
Sponsored by
Sollis Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lumbosacral Radiculopathy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Must be between 18 and 70 years of age (inclusive) at time the Informed Consent Form (ICF) is signed. Must have a primary diagnosis of unilateral lumbar and/or lumbosacral radiculopathy defined by all of the following: supported by history, physical examination, and radiologic pathology consistent with a disc protrusion, non-sequestered extrusion, or sequestered fragment, as evidenced by magnetic resonance imaging (MRI), that is consistent with the clinical signs and symptoms of lumbar or lumbosacral radiculopathy. Subject's pain must have a radicular component (radiation into the leg along the L3-S1 [inclusive] dermatomal pattern) and may or may not be associated with additional neuropathic features such as reduced sensory, motor, or deep tendon reflexes. Worst radicular pain symptoms should be confined to a single dermatomal level as confirmed on physical examination (to allow determination of injection level). The NRS leg pain must be ≥4, must extend below the knee and be consistent with one of the dermatomal distributions noted above. Radicular pain symptoms in the current episode must have been present for at least 8 weeks, but not longer than 9 months at the time of Screening. Subjects must not have had a significant reduction in the pain in the 1 to 2 weeks before Screening (i.e., pain must not be improving significantly based on the discretion of the Investigator). Baseline 0-10 NRS average pain score localized to at least 1 target location must be ≥6 and ≤9. Subjects must be able to separately distinguish and characterize the contribution of back and leg pain to their overall pain to independently assess the response of each to intervention. Investigators must confirm that subjects can do so based upon pain diagrams and direct questioning. Subjects must have had no significant improvement following a minimum of 8 weeks of the following categories prior to Screening: Mechanical intervention (eg, physical therapy, home exercise program, heat compresses/massage, chiropractic treatment), and Over-the-counter analgesics (non-steroidal anti-inflammatory drugs, topical patches/creams/gels/ointments). Subjects of childbearing potential must have a negative (serum) pregnancy test at Screening and a negative urine pregnancy test within 24 hours before the injection procedure and must commit to either abstain continuously from sexual intercourse or to use, at the Investigator's discretion, highly effective birth control during the study period. Must sign an ICF indicating that they understand the purpose and any risks associated with the procedure required for the study and is willing to participate in the study to completion. Must be willing and able to adhere to the prohibitions and restrictions specified in the protocol. Must be able to read, write, understand, and complete study-related tasks, and adequately communicate regularly with the site. Must have an email address and access to the internet from an electronic device in order to complete daily EDQ information. Exclusion Criteria: Subject has significant pain unrelated to the lumbar or lumbosacral radiculopathy (eg, knee pain, hip pain, or rib pain) that, in the Investigator's opinion, could require chronic analgesic treatment and interfere with the assessment of IP therapeutic effect. Subject has radiological findings or presenting features such as severe motor weakness (with or without reduced deep tendon reflexes) and is a candidate for surgical referral (i.e., progressive neurologic deficit or cauda equina syndrome). Subject has evidence of pathology on MRI (obtained during the current episode of pain) that may result in pain unlikely to be addressed by the IP, including but not limited to the following: Symptomatic (eg, neurogenic claudication) radiographically confirmed central stenosis at any level or diffuse spine pathology. Non-inflammatory or bony lateral recess or foraminal stenosis such as that caused by facet hypertrophy or osteophytes that is a significant contributor to the current episode of pain. Spondylolisthesis > 3 mm at the level of the involved dermatome. Evidence of a lumbar vertebral compression fracture, synovial cyst, lumbar epidural lipomatosis, or extraforaminal pathology. Subject has a history of, or current diagnosis of, fibromyalgia. Subject has a history of lumbar surgery and/or intradiscal interventions (including discography). Subject has an active infection (eg, fever or other objective evidence of an infection within 7 days of the planned injection) or any skin condition visible at the injection site at time of Screening. Subject has evidence of a coagulation abnormality or history of abnormal bleeding or is on anticoagulation therapy at time of Screening. Subject has current untreated or clinically significant anxiety and/or depression as defined by the following: Beck Anxiety Inventory® (BAI®) score ≥29 or, Beck Depression Inventory-2® (BDI®) score ≥31. Changes in medications administered for treatment of depression or anxiety within the 30 days before Screening. Note: If a subject is taking antidepressant or anti-anxiety medication, either for the treatment of depression/anxiety or as an analgesic adjunct, the subject must agree to maintain a stable dose (no change in dosage) for the first 3 months of the study. Subject is planning to receive a spinal injection or spine procedure while participating in this study, unless this procedure can be postponed until study completion. Subject has received an ESI, nerve block, or other similar procedure in the lumbosacral area performed during the 8 weeks prior to Screening. Subject is receiving or has received the following medications prohibited in this study: Short-acting opioids taken as needed (PRN) less than 4 days a week (hydrocodone, oxycodone, tramadol, etc.) within 14 days prior to Screening. Long-acting opioids or short-acting opioids taken regularly, i.e., more than 4 days a week within 30 days prior to Screening. Anticonvulsants for treatment of radicular leg pain if the dose has changed in the 30 days prior to Screening or the subject is unable to maintain a stable dose for the first 3 months of the study. Systemic corticosteroids within the 30 days prior to Screening. Central alpha-agents, including clonidine-containing medication or dexmedetomidine within 30 days before Screening. Subject has a history of treatment, or has been recommended for treatment, of alcohol or drug use disorder treatment within the year prior to Screening. Subject has a known or suspected allergy, hypersensitivity, or intolerance to any of the following: Clonidine/clonidine hydrochloride. Polylactic acid (found in products such as Lupron Depot®, Atridox®, some types of dermal fillers, and some types of sutures). Radiographic contrast agents or any other medications to be used during the procedure. Subject has recent (within previous 8 weeks) symptomatic hypotension, orthostatic hypotension, or bradycardia. Subject has a Body Mass Index (BMI) or a body habitus that, in the Investigator's judgment, would require a needle longer than a 3.5-inch Tuohy needle. Subject has participated in a clinical trial of an investigational drug or device within 30 days of Screening. Subject has previously participated in a clinical trial sponsored by Sollis Therapeutics (including Protocol Number STX-015-18-01 and Protocol Number STX-015-18-02). Subject has any medical condition that, in the Investigator's opinion, could adversely impact study participation or safety, require chronic analgesic treatment, or interfere with the pain assessments (eg, painful neuropathy, rheumatologic disorder, etc.). Subject has worker's compensation benefits and/or is involved in any litigation related to his/her radicular pain. Subject is currently pregnant or breast feeding, planning to become pregnant or, if of childbearing potential, is unwilling to have a pregnancy test administered or use appropriate, highly effective contraception. Subject is unable or unwilling to undergo MRI examinations. Subject is unable to adequately rate his/her pain in the EDQ. Presence of active kidney disease, as evidenced by an estimated glomerular filtration rate of less than 60 mL/min/1.73m2 utilizing the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects will be excluded from randomization if they have any of the following during the 7-day Baseline Period: Two or more ratings of NRS Average Leg Pain and/or Back Pain > 9 (showing severe pain), Two or more ratings of NRS Average Leg Pain and/or Back Pain ≥ 9 AND ≤ 3 (showing inconsistent pain). Employees of Sollis Therapeutics, Novotech Health Holdings, or study site personnel directly affiliated with this study, and their immediate family members. Immediate family is defined as a spouse, parent, child, or sibling, whether biological or legally adopted.

Sites / Locations

  • Sollis Clinical Study Site 30Recruiting
  • Sollis Clinical Study Site 14Recruiting
  • Sollis Clinical Study SiteRecruiting
  • Sollis Clinical Study Site 18Recruiting
  • Sollis Clinical Study Site 21Recruiting
  • Sollis Clinical Study Site 19Recruiting
  • Sollis Clinical Study Site 46Recruiting
  • Sollis Clinical Study SiteRecruiting
  • Sollis Clinical Study Site 47Recruiting
  • Sollis Clinical Study Site 27Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Clonidine Micropellets Injection

Sham Insertion

Arm Description

Clonidine Micropellets single dose injection into the lumbar epidural space

Sham Control non-epidural needle placement

Outcomes

Primary Outcome Measures

Primary efficacy: Pain Intensity Difference (PID) for the average pain Numeric Rating Scale (NRS) from baseline to D90 in lumbosacral radiculopathy.
Difference in average pain score, using a scale of 0-10 with 0 no pain and 10 worst possible pain, from baseline to day 90.
Incidence of Treatment-Emergent Adverse Events.
Difference in incidence of adverse events and treatment due to radicular leg pain from Baseline to day 90 post injection based on physical examination findings and vital signs measurements.
Incidence of symptomatic hypotension as an adverse event of special interest.
Difference in incidence defined as low blood pressure associated with subject-reported symptoms of dizziness, lightheadedness, syncope, blurred vision, or nausea.

Secondary Outcome Measures

Change in Oswestry Disability Index (ODI) score
6 categories of 10 question, each question is scored from 0-5 (minimum to maximum). The scores range from 0-100% with lower scores meaning less disability.
Difference in Rescue medication consumption.
Consumption from baseline through day 30
Change in Average and Worst NRS from Day 90 post injection to 12 months post injection.
Difference in NRS pain scores from Day 90 to month 12 post injection.
Percent of subjects with significant improvement in pain.
30 percent improvement in pain from baseline to day 90.

Full Information

First Posted
October 27, 2022
Last Updated
October 5, 2023
Sponsor
Sollis Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05614648
Brief Title
Sciatica Epidural Radiculopathy Experimental New Interventional TherapY Clonidine Micropellet
Acronym
SERENITY CM
Official Title
A Phase 3, Prospective, Multicenter, Randomized, Double-blind, Sham-controlled Study of the Efficacy and Safety of STX-015 in the Treatment of Pain Associated With Lumbosacral Radiculopathy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 19, 2023 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sollis Therapeutics, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
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
This study will evaluate the safety and effectiveness of a new pain medication in development, clonidine micropellet. Participants will receive a single injection of either clonidine micropellet or sham injection for the treatment of low back and leg pain from sciatica.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lumbosacral Radiculopathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Clonidine Micropellet vs Sham-Control
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Double-Blinded
Allocation
Randomized
Enrollment
340 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Clonidine Micropellets Injection
Arm Type
Active Comparator
Arm Description
Clonidine Micropellets single dose injection into the lumbar epidural space
Arm Title
Sham Insertion
Arm Type
Sham Comparator
Arm Description
Sham Control non-epidural needle placement
Intervention Type
Drug
Intervention Name(s)
Clonidine Micropellets
Intervention Description
0.975 mg clonidine hydrochloride as 3 micropellets administered in one injection
Intervention Type
Device
Intervention Name(s)
Tuohy epidural needle
Intervention Description
18-gauge Tuohy epidural needle using a custom-built injector
Primary Outcome Measure Information:
Title
Primary efficacy: Pain Intensity Difference (PID) for the average pain Numeric Rating Scale (NRS) from baseline to D90 in lumbosacral radiculopathy.
Description
Difference in average pain score, using a scale of 0-10 with 0 no pain and 10 worst possible pain, from baseline to day 90.
Time Frame
Baseline to day 90
Title
Incidence of Treatment-Emergent Adverse Events.
Description
Difference in incidence of adverse events and treatment due to radicular leg pain from Baseline to day 90 post injection based on physical examination findings and vital signs measurements.
Time Frame
Baseline to day 90
Title
Incidence of symptomatic hypotension as an adverse event of special interest.
Description
Difference in incidence defined as low blood pressure associated with subject-reported symptoms of dizziness, lightheadedness, syncope, blurred vision, or nausea.
Time Frame
Baseline to day 90
Secondary Outcome Measure Information:
Title
Change in Oswestry Disability Index (ODI) score
Description
6 categories of 10 question, each question is scored from 0-5 (minimum to maximum). The scores range from 0-100% with lower scores meaning less disability.
Time Frame
Baseline to month12
Title
Difference in Rescue medication consumption.
Description
Consumption from baseline through day 30
Time Frame
Baseline to month12
Title
Change in Average and Worst NRS from Day 90 post injection to 12 months post injection.
Description
Difference in NRS pain scores from Day 90 to month 12 post injection.
Time Frame
from Day 90 to month 12 post injection
Title
Percent of subjects with significant improvement in pain.
Description
30 percent improvement in pain from baseline to day 90.
Time Frame
Baseline to day 90

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must be between 18 and 70 years of age (inclusive) at time the Informed Consent Form (ICF) is signed. Must have a primary diagnosis of unilateral lumbar and/or lumbosacral radiculopathy defined by all of the following: supported by history, physical examination, and radiologic pathology consistent with a disc protrusion, non-sequestered extrusion, or sequestered fragment, as evidenced by magnetic resonance imaging (MRI), that is consistent with the clinical signs and symptoms of lumbar or lumbosacral radiculopathy. Subject's pain must have a radicular component (radiation into the leg along the L3-S1 [inclusive] dermatomal pattern) and may or may not be associated with additional neuropathic features such as reduced sensory, motor, or deep tendon reflexes. Worst radicular pain symptoms should be confined to a single dermatomal level as confirmed on physical examination (to allow determination of injection level). The NRS leg pain must be ≥4, must extend below the knee and be consistent with one of the dermatomal distributions noted above. Radicular pain symptoms in the current episode must have been present for at least 8 weeks, but not longer than 9 months at the time of Screening. Subjects must not have had a significant reduction in the pain in the 1 to 2 weeks before Screening (i.e., pain must not be improving significantly based on the discretion of the Investigator). Baseline 0-10 NRS average pain score localized to at least 1 target location must be ≥6 and ≤9. Subjects must be able to separately distinguish and characterize the contribution of back and leg pain to their overall pain to independently assess the response of each to intervention. Investigators must confirm that subjects can do so based upon pain diagrams and direct questioning. Subjects must have had no significant improvement following a minimum of 8 weeks of the following categories prior to Screening: Mechanical intervention (eg, physical therapy, home exercise program, heat compresses/massage, chiropractic treatment), and Over-the-counter analgesics (non-steroidal anti-inflammatory drugs, topical patches/creams/gels/ointments). Subjects of childbearing potential must have a negative (serum) pregnancy test at Screening and a negative urine pregnancy test within 24 hours before the injection procedure and must commit to either abstain continuously from sexual intercourse or to use, at the Investigator's discretion, highly effective birth control during the study period. Must sign an ICF indicating that they understand the purpose and any risks associated with the procedure required for the study and is willing to participate in the study to completion. Must be willing and able to adhere to the prohibitions and restrictions specified in the protocol. Must be able to read, write, understand, and complete study-related tasks, and adequately communicate regularly with the site. Must have an email address and access to the internet from an electronic device in order to complete daily EDQ information. Exclusion Criteria: Subject has significant pain unrelated to the lumbar or lumbosacral radiculopathy (eg, knee pain, hip pain, or rib pain) that, in the Investigator's opinion, could require chronic analgesic treatment and interfere with the assessment of IP therapeutic effect. Subject has radiological findings or presenting features such as severe motor weakness (with or without reduced deep tendon reflexes) and is a candidate for surgical referral (i.e., progressive neurologic deficit or cauda equina syndrome). Subject has evidence of pathology on MRI (obtained during the current episode of pain) that may result in pain unlikely to be addressed by the IP, including but not limited to the following: Symptomatic (eg, neurogenic claudication) radiographically confirmed central stenosis at any level or diffuse spine pathology. Non-inflammatory or bony lateral recess or foraminal stenosis such as that caused by facet hypertrophy or osteophytes that is a significant contributor to the current episode of pain. Spondylolisthesis > 3 mm at the level of the involved dermatome. Evidence of a lumbar vertebral compression fracture, synovial cyst, lumbar epidural lipomatosis, or extraforaminal pathology. Subject has a history of, or current diagnosis of, fibromyalgia. Subject has a history of lumbar surgery and/or intradiscal interventions (including discography). Subject has an active infection (eg, fever or other objective evidence of an infection within 7 days of the planned injection) or any skin condition visible at the injection site at time of Screening. Subject has evidence of a coagulation abnormality or history of abnormal bleeding or is on anticoagulation therapy at time of Screening. Subject has current untreated or clinically significant anxiety and/or depression as defined by the following: Beck Anxiety Inventory® (BAI®) score ≥29 or, Beck Depression Inventory-2® (BDI®) score ≥31. Changes in medications administered for treatment of depression or anxiety within the 30 days before Screening. Note: If a subject is taking antidepressant or anti-anxiety medication, either for the treatment of depression/anxiety or as an analgesic adjunct, the subject must agree to maintain a stable dose (no change in dosage) for the first 3 months of the study. Subject is planning to receive a spinal injection or spine procedure while participating in this study, unless this procedure can be postponed until study completion. Subject has received an ESI, nerve block, or other similar procedure in the lumbosacral area performed during the 8 weeks prior to Screening. Subject is receiving or has received the following medications prohibited in this study: Short-acting opioids taken as needed (PRN) less than 4 days a week (hydrocodone, oxycodone, tramadol, etc.) within 14 days prior to Screening. Long-acting opioids or short-acting opioids taken regularly, i.e., more than 4 days a week within 30 days prior to Screening. Anticonvulsants for treatment of radicular leg pain if the dose has changed in the 30 days prior to Screening or the subject is unable to maintain a stable dose for the first 3 months of the study. Systemic corticosteroids within the 30 days prior to Screening. Central alpha-agents, including clonidine-containing medication or dexmedetomidine within 30 days before Screening. Subject has a history of treatment, or has been recommended for treatment, of alcohol or drug use disorder treatment within the year prior to Screening. Subject has a known or suspected allergy, hypersensitivity, or intolerance to any of the following: Clonidine/clonidine hydrochloride. Polylactic acid (found in products such as Lupron Depot®, Atridox®, some types of dermal fillers, and some types of sutures). Radiographic contrast agents or any other medications to be used during the procedure. Subject has recent (within previous 8 weeks) symptomatic hypotension, orthostatic hypotension, or bradycardia. Subject has a Body Mass Index (BMI) or a body habitus that, in the Investigator's judgment, would require a needle longer than a 3.5-inch Tuohy needle. Subject has participated in a clinical trial of an investigational drug or device within 30 days of Screening. Subject has previously participated in a clinical trial sponsored by Sollis Therapeutics (including Protocol Number STX-015-18-01 and Protocol Number STX-015-18-02). Subject has any medical condition that, in the Investigator's opinion, could adversely impact study participation or safety, require chronic analgesic treatment, or interfere with the pain assessments (eg, painful neuropathy, rheumatologic disorder, etc.). Subject has worker's compensation benefits and/or is involved in any litigation related to his/her radicular pain. Subject is currently pregnant or breast feeding, planning to become pregnant or, if of childbearing potential, is unwilling to have a pregnancy test administered or use appropriate, highly effective contraception. Subject is unable or unwilling to undergo MRI examinations. Subject is unable to adequately rate his/her pain in the EDQ. Presence of active kidney disease, as evidenced by an estimated glomerular filtration rate of less than 60 mL/min/1.73m2 utilizing the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects will be excluded from randomization if they have any of the following during the 7-day Baseline Period: Two or more ratings of NRS Average Leg Pain and/or Back Pain > 9 (showing severe pain), Two or more ratings of NRS Average Leg Pain and/or Back Pain ≥ 9 AND ≤ 3 (showing inconsistent pain). Employees of Sollis Therapeutics, Novotech Health Holdings, or study site personnel directly affiliated with this study, and their immediate family members. Immediate family is defined as a spouse, parent, child, or sibling, whether biological or legally adopted.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Robert Daly, MS, PhD
Phone
614-636-4971
Email
robert@sollistx.com
First Name & Middle Initial & Last Name or Official Title & Degree
Beth Mastin, MBA
Phone
614-636-4971
Email
bmastin@sollistx.com
Facility Information:
Facility Name
Sollis Clinical Study Site 30
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
22205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mehul Desai
Facility Name
Sollis Clinical Study Site 14
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dawood Sayed
Facility Name
Sollis Clinical Study Site
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gupta Mayank
Facility Name
Sollis Clinical Study Site 18
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Leonardo Kapural
Facility Name
Sollis Clinical Study Site 21
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Salim Hayek
Facility Name
Sollis Clinical Study Site 19
City
Edmond
State/Province
Oklahoma
ZIP/Postal Code
73013
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Douglas Beall
Facility Name
Sollis Clinical Study Site 46
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gregory Moore
Facility Name
Sollis Clinical Study Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75240
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Muhammad Zulqarnain
Facility Name
Sollis Clinical Study Site 47
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Todd Bertoch
Facility Name
Sollis Clinical Study Site 27
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alaa Abd-Elsayed

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Sciatica Epidural Radiculopathy Experimental New Interventional TherapY Clonidine Micropellet

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