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Neck PainNCT03066960

Radiofrequency Neurotomy for Chronic Facet Joint Related Neck Pain

A study testing Radiofrequency neurotomy in people with Neck Pain, run by Oslo University Hospital at 2 sites in Norway.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a single-center, double blind, sham-controlled randomized trial (N: 34) to assess the long term efficacy of RF neurotomy of cervical medial branches. Patients with chronic unilateral neck pain who are found eligible and achieve ≥50% pain relief of two predictive and comparative test blocks will be included in… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Neck Pain
What is being tested?
Radiofrequency neurotomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
34 participants
Where
2 sitesNorway
Study dates
1 Jan 2019to 14 Dec 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Min 18 years and Maximum 80 years
  • Read and understand Norwegian
  • Stable neck pain >12 months, with or without unilateral headache
  • Average of worst pain intensity last three days ≥ 4 out of maximum 10
  • Neck Disability Index >15 points or > 30 percentage points.
  • At least two predictive blocks ≥ 50% pain relief 30 to 60 minutes after lidocaine and 30 to 180 minutes after bupivacaine .

Who cannot join

  • Serious cervical pathology (acute cervical disc herniation, radiculopathy, myelopathy, spinal anomalies and chronic widespread pain
  • Opioid consumption > 50 morphine equivalents/day
  • Ongoing litigation process and applying for disability insurance/benefits
  • Serious psychiatric disorder (DSM-IV-TR) diagnosed at a psychiatric unit, including suicidal thoughts and somatization (from Hopkins Symptom Check List 25 ≥ 2.5)
  • Ongoing addictive behavior ( diagnostic criteria in Statistical Manual, 4th Edition)
  • Unstable medical condition (ASA 4, serious vascular disease like unstable angina)
Show all 13Show fewer
  • Bacterial infection
  • Malignancy
  • Chronic generalized pain
  • Hypersensitive to contrast agents or local anesthetics
  • Pregnancy
  • Bleeding diathesis
  • Previously radiofrequency neurotomy

Trial locations and contacts

2 sites in 1 country.

Gunnvald Kvarstein, Dr. Med contact

+47 92295309

gunnvald.kvarstein@uit.no

Norway2 sites, 2 recruiting
  • Department of Pain Management and Research Oslo University Hospital

    Oslo, 4950

    Gunnvald Kvarstein, PhD, +47923026161, gunnvald.kvarstein@uit.no

    Bård Lundeland, PhD, 4+4723026161, bard.lundeland@ous-hf.no

    Recruiting
  • Department for Pain and Complex Disorders

    Trondheim, Torgarden, 3250

    Petter Borchgrevink, PhD, +4772822500, petter.borchgrevink@ntnu.no

    Recruiting

Other trials in Norway

About this study

Official title: Long-term Efficacy of Radiofrequency Neurotomy for Chronic Zygapophysial (Facet) Joint Related Neck Pain

This is a single-center, double blind, sham-controlled randomized trial (N: 34) to assess the long term efficacy of RF neurotomy of cervical medial branches. Patients with chronic unilateral neck pain who are found eligible and achieve ≥50% pain relief of two predictive and comparative test blocks will be included in the trial in a primary analysis. We will further test whether a strict selection of ≥80% pain relief better predicts efficacious RF neurotomy compared with a less strict selection of ≥50% to <80%. After 6 months sham-treated patients may also be offered active unblinded RF treatment. Demographic and clinical data will be recorded at baseline while primary and secondary outcome measurements are recollected after 1, 3, 6, 9 and 12 months. Primary outcome measurements include self-reported neck function (NDI) and pain relief after 6 months.

Read the detailed description

Chronic neck pain represents a common health problem. The mechanisms appear to be multifactorial. Researchers have suggested a disturbed interplay between the deep neck muscles and facet joints. In Europe and the US radiofrequency neurotomy has become a common treatment. The evidence base, however, is still insufficient. Thus, a double blind, sham-controlled, randomized, single-center trial is carried out. Based on current data and a single center study design, 34 randomized participants, completing the trial, have shown adequate to obtain sufficient statistical power. To simplify the data collection a digital internet based program is used. Patients with chronic unilateral neck pain, referred to Oslo University Hospital or responding to public announcements, and not responding to non-interventional treatment will be screened. Those who are found eligible and achieve ≥50% pain relief after predictive and comparative test blocks, will be included in the study. We will further test whether a strict selection of ≥80% pain relief better predicts efficacious RF neurotomy compared with a less strict selection of ≥50% to <80%. After 6 months participants who received sham and still suffer from neck pain, will be offered unblinded RF neurotomy and additional 12 month unblinded follow up if the results support this treatment. Demographic and clinical data will be recorded at baseline. The primary and secondary outcome measurements are recollected after 1, 3, 6, 9 and 12 months. Primary outcome measurements include self-reported neck function (NDI) and pain relief after 6 months. Regression analyses will be used to identify how pain relief of two test blocks and pain catastrophizing predict response to RF neurotomy. If RF neurotomy is found superior to sham treatment, this may be implemented in the national treatment program for selected patients with chronic neck pain.

Conditions
Neck Pain
Being tested
Radiofrequency neurotomy, Sham treatment
Keywords
radiofrequency neurotomy, zygapophyseal joint
Medical subject headings
Neck Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Radiofrequency neurotomyProcedure or surgery

    RF neurotomy represents a nerve destructive, coagulating technique affecting the conduction through all nerve fibers.

  • Sham treatmentProcedure or surgery

    Sham treatment represents no coagulation of the nerve and will not affect the nerve conduction.

Study groups in NCT03066960
Study groupRoleWhat they receive
Radiofrequency neurotomy groupActive comparatorUnilateral radiofrequency neurotomy of medial branches to the dorsal ramus at one or two cervical levels
Receives: Procedure: Radiofrequency neurotomy
Sham groupSham comparatorUnilateral sham treatment of medial branches to the dorsal ramus at one or two cervical levels
Receives: Procedure: Sham treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in neck function after RF neurotomy vs sham treatment

    Two independent group comparison of change of Neck Disability Index scores -continuous variable 0-50)

    Measured: 6 months

  2. Change in pain intensity (numeric pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (triplicate values from three consecutive days on a numeric pain scale 0-10 which provides a continuous variable)

    Measured: 6 months

Secondary outcomes (27)
  1. Change in neck function after RF neurotomy vs sham treatment

    Two independent group comparison of change of Neck Disability Index scores -continuous variable 0-50

    Measured: 12 months

  2. Change in pain intensity (numeric pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (triplicate values from three consecutive days on a numeric pain scale 0-10 which provides a continuous variable)

    Measured: 1 month

  3. Change in pain intensity (numeric pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (triplicate values from three consecutive days on a numeric pain scale 0-10 which provides a continuous variable)

    Measured: 3 months

  4. Change in pain intensity (numeric pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (triplicate values from three consecutive days on a numeric pain scale 0-10 which provides a continuous variable)

    Measured: 9 months

  5. Change in pain intensity (numeric pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (triplicate values from three consecutive days on a numeric pain scale 0-10 which provides a continuous variable)

    Measured: 12 months

  6. Change in pain intensity (categorical pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (categorical 6-point pain scale with the alternatives worse, unchanged, <50% reduced, ≥50% reduced, and pain free which provides a categorial variable)

    Measured: 1 month

  7. Change in pain intensity (categorical pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (categorical 6-point pain scale wth the alternatives worse, unchanged, <50% reduced, ≥50% reduced, and pain free which provides a categorial variable)

    Measured: 3 months

  8. Change in pain intensity (categorical pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (categorical 6-point pain scale wth the alternatives worse, unchanged, <50% reduced, ≥50% reduced, and pain free which provides a categorial variable)

    Measured: 6 months

  9. Change in pain intensity (categorical pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (categorical 6-point pain scale wth the alternatives worse, unchanged, <50% reduced, ≥50% reduced, and pain free which provides a categorial variable)

    Measured: 9 months

  10. Change in pain intensity (categorical pain scale) after RF neurotomy vs sham treatment

    Two independent group comparison of change in pain intensity (categorical 6-point pain scale wth the alternatives worse, unchanged, <50% reduced, ≥50% reduced, and pain free which provides a categorial variable)

    Measured: 12 months

  11. Change in health related quality of life after RF neurotomy vs sham treatment

    Two independent group comparison of change of EuroQuol-5-Dimensions Index scores (continuous variable from -0.59 to 1.00)

    Measured: 6 months

  12. Change in health related quality of life after RF neurotomy vs sham treatment

    Two independent group comparison of change of EuroQuol-5-Dimensions Index scores (continuous variable from -0.59 to 1.00)

    Measured: 12 months

  13. Change in drug consumption after RF neurotomy vs sham treatment

    Two independent group comparison of change of the numbers of analgesic drugs (continuous variable)

    Measured: 6 months

  14. Change in drug consumption after RF neurotomy vs sham treatment

    Two independent group comparison of change of the numbers of analgesic drugs (continuous variable)

    Measured: 12 months

  15. Change in number of neck/pain treatments after RF neurotomy vs sham treatment

    Two independent group comparison of change of the numbers of neck/pain treatments (continuous variable)

    Measured: 6 months

  16. How highly positive response to test block influences neck function after RF treatment

    Regression analysis on how ≥80% pain relief (independent categorical variable) predicts >15% reduction of Neck disability Score (categorical variable) after RF neurotomy

    Measured: 6 months

  17. How moderately positive response to test block influences neck function after RF treatment

    Regression analysis on how ≥50% and <80% pain relief (independent categorical variable) predicts >15% reduction of Neck disability Score (categorical variable) after RF neurotomy

    Measured: 6 months

  18. How highly positive response to test block influences 30% pain relief after RF treatment

    Regression analysis on how ≥80% pain relief (independent categorical variable) predicts >30% reduction in pain intensity (categorical variable) after RF neurotomy

    Measured: 6 months

  19. How moderately positive response to test block influences 30% pain relief after RF treatment

    Regression analysis on how ≥50% and <80% pain relief (independent categorical variable) predicts >30% reduction in pain intensity (categorical variable) after RF neurotomy

    Measured: 6 months

  20. How highly positive response to test block influences 50% pain relief after RF treatment

    Regression analysis on how ≥80% pain relief (independent categorical variable) predicts >50% reduction in pain intensity (categorical variable) after RF neurotomy

    Measured: 6 months

  21. How moderately positive response to test block influences 50% pain relief after RF treatment

    Regression analysis on how ≥50 and <80% pain relief (independent categorical variable) predicts >50% reduction in pain intensity (categorical variable) after RF neurotomy

    Measured: 6 months

  22. How catastrophizing influences neck function after RF treatment.

    Regression analysis on how Pain Catastrophizing Scale score ≥30 (independent categorical variable) predict ≥ 15% reduction of Neck Disability Score (categorical variable) after RF neurotomy vs Pain Catastrophizing Scale score < 30

    Measured: 6 months

  23. How catastrophizing influences pain relief after RF treatment.

    Regression analysis on how Pain Catastrophizing Scale scores ≥30 (independent categorical variable) predict >30% reduction in pain intensity (categorical variable) after RF neurotomy vs Pain Catastrophizing Scale scores < 30

    Measured: 6 months

  24. Change in mental distress after RF neurotomy vs sham treatment.

    Two independent group comparison of change in Hopkin Symptom Check List (HSCL 25) sumscore which is a continuous variable on anxiety and depressive symptoms, ranging from 1 (normal) to 4 (worse)

    Measured: 6 months

  25. Change in mental distress after RF neurotomy vs sham treatment.

    Two independent group comparison of change in Hopkin Symptom Check List (HSCL 25) sumscore which is a continuous variable on anxiety and depressive symptoms, ranging from 1 (normal) to 4 (worse)

    Measured: 12 months

  26. Change in sleep disturbances after RF neurotomy vs sham treatment.

    Two independent group comparison of change in sleep. Sleep Subscale in Neck Disability Index part 7. A continuous variable based on a 6 point scale ranging from 0 to 6 where 0 is no problem and 6 i severe insomnia.

    Measured: 6 months

  27. Change in sleep disturbances after RF neurotomy vs sham treatment.

    Two independent group comparison of change in sleep. Sleep Subscale in Neck Disability Index part 7. A continuous variable based on a 6 point scale ranging from 0 to 6 where 0 is no problem and 6 i severe insomnia.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Mar 2017
  2. Study start1 Jan 2019
  3. Primary completion14 Dec 2024 (estimated)
  4. Study completion14 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
34 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03066960
Sponsor's protocol ID
2015/2194
Status last verified
Dec 2023
First submitted
20 Feb 2017
Last updated
11 Dec 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual Participant Data Sharing Plan. In accordance with the general data sharing policy at OUH, the deidentified, individual data can be made available for external researchers from 9 months to 5 years after publication. However, to get access the researchers need to provide a methodologically sound proposal in accordance with the institutional guidelines and sign a data access agreement.

Questions about this trial

What is this clinical trial studying?

A study testing Radiofrequency neurotomy in people with Neck Pain, run by Oslo University Hospital at 2 sites in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 11 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Gunnvald Kvarstein, Dr. Med (+47 92295309, gunnvald.kvarstein@uit.no), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in neck function after RF neurotomy vs sham treatment (time frame: 6 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2023.

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