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Showing 1-20 of 47 trials
NCT06615518
The goal of this clinical trial is to compare the clinical effectiveness of Full Endoscopic Lumbar Discectomy (FELD) and Microdiscectomy (MD) in patients aged 18-85 with single-level lumbar disc herniation who have not undergone prior lumbar surgery. This study also aims to perform a radiological analysis of MRI scans before and after treatment to optimize patient selection and surgical strategies. The main questions it aims to answer are: * Does FELD provide superior early postoperative pain relief (measured by VAS) compared to MD? * Does FELD offer better functional recovery (measured by COMI and ODI scores) postoperatively compared to MD? * Can radiological analysis of pre- and post-operative MRI images help optimize patient qualification and guide surgical strategies? Researchers will compare patients undergoing FELD to those undergoing MD to see if endoscopic techniques result in faster recovery and lower early postoperative pain while maintaining similar long-term outcomes. The study will also analyze how MRI findings correlate with clinical outcomes to refine operative decision-making. Participants will: * Undergo either FELD or MD surgery * Complete VAS, COMI, and ODI questionnaires at pre-specified follow-up intervals (1, 3, 6, and 12 months post-surgery) * Have MRI scans 24 hours before surgery, 24 hours after surgery, and at each follow-up to assess disc recurrence, residual pathology, and to optimize surgical strategies.
NCT07573124
Lumbar radiculopathy (LR), often caused by disc herniation, results in significant pain, disability, and reduced quality of life. Spinal Mobilization with Leg Movement (SMWLM) is a manual technique that has shown promise, while mechanical lumbar traction is used to reduce nerve compression, though its standalone effectiveness is debated. This randomized controlled trial aims to compare the combined effect of SMWLM plus mechanical lumbar traction against SMWLM alone, both administered with conventional physiotherapy. Outcomes will be assessed over 4 weeks to determine if the combined intervention offers superior pain relief, functional improvement, and range of motion in patients with unilateral L4-L5 or L5-S1 radiculopathy.
NCT07313566
The R³ trial is a multicentre cluster randomized controlled trial evaluating an evidence-based, person-centred rehabilitation pathway for patients undergoing lumbar surgery for radicular pain. The pathway includes structured pre-, peri-, and postoperative rehabilitation, early postoperative mobilization, case management, early return-to-work (RTW) guidance, and patient empowerment. Clusters (hospitals) are randomized to implement the R³ pathway (intervention) or continue usual care (control). The primary aim is to determine whether the R³ pathway reduces time to return to work compared with usual care.
NCT05444751
The purpose of this study is to determine the optimal anesthetic routine for lumbar decompression surgery. General Anesthesia is the standard of care in spine surgery. Spinal anesthesia in decompressive procedures can be the new standard of care. Recently, it has been found that regional analgesia is option that has been shown to improve pain and opioid-related outcomes after spine surgery, but has not yet been studied in combination with spinal anesthesia. This is study that consists of two groups: standard of care general anesthesia with a nerve block and a spinal anesthesia with nerve block. Patients are randomized to either of the two groups. There will be 71 patients enrolled in each group for this study.
NCT07509580
Lumbar radiculopathy caused by conditions such as lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS) can lead to chronic pain and reduced quality of life. In patients who do not respond to conservative treatments, minimally invasive procedures such as transforaminal epidural steroid injection (TFESI) and pulsed radiofrequency (pRF) applied to the dorsal root ganglion (DRG) are commonly used. This study aims to compare treatment responses between patients with lumbar disc herniation and those with lumbar spinal stenosis who have undergone TFESI combined with dorsal root ganglion pulsed radiofrequency. Pain levels and clinical outcomes will be evaluated to determine whether the underlying condition affects treatment effectiveness. The results of this study may help guide clinicians in selecting the most appropriate treatment approach for patients with lumbar radiculopathy.
NCT07384832
This study will be a randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 72 participants will be selected and randomly allocated into two treatment groups (36 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B. Group A will receive dynamic stretching along with routine physiotherapy. Routine physiotherapy will include TENS (15 minutes), hot moist pack (10 minutes), soft tissue mobilisation (5-7 minutes), abdominal bracing, pelvic tilt, and alternate leg extension exercises. The dynamic stretching part will include the slump stretch, cat-camel stretch, hamstring sweeps, child pose stretch, and overhead lateral stretch. Each stretch will be performed in 2 sets of 15-20 repetitions with 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks. Group B will receive slider neurodynamic mobilisation along with the same routine physiotherapy protocol as group A. Slider neurodynamic mobilisation will be performed in the slump position, sitting at the edge of the plinth with the thighs parallel to each other and arms crossing behind the back. The examiner asked the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion with 3 sets of 1-minute sliders and 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks. All participants will undergo assessments at baseline, at the end of the 3rd week, and at the end of the 6th week.
NCT07524686
Low back pain with lumbar radiculopathy is a common condition that significantly affects functional ability and quality of life. Manual therapy is widely used as a first-line treatment to reduce pain and improve mobility. This study aims to compare the effectiveness of spinal mobilization with leg movement (SMWLM) and neurodynamic mobilization in patients with lumbar radiculopathy. A total of 20 participants were randomly assigned into two groups. One group received SMWLM, while the other group received neurodynamic mobilization of the sciatic nerve over a treatment period of six weeks. Outcomes included pain intensity, quality of life, and hip range of motion. The results of this study aim to identify the more effective intervention for improving clinical outcomes in patients with lumbar radiculopathy.
NCT06643572
This study aims to evaluate the impact of pre-procedure training using a 3D simulator, based on lumbar CT images, on the success rate and efficiency of lumbar transforaminal steroid injections in patients who are expected to be difficult to treat. The training is provided to practitioners prior to performing the procedure on these patients.
NCT07458399
This study will be conducted to evaluate the effect of sciatic nerve slider mobilization on pain intensity. Also, to evaluate the impact of sciatic nerve mobilization on functional disability, and to determine the influence of sciatic nerve slider neurodynamics on functional balance performance.
NCT07080047
Radiculopathy or nerve root pain arises from disc herniation, spinal stenosis/post-operative scarring, radiating down the leg in a dermatomal pattern. Lumbosacral radiculopathy is defined as a "disarticulation of disc components nucleus pulpous or annulus fibrosis beyond the intervertebral disc space. Low back pain (LBP) is one of the most widely recognized conditions that debilitate people's functional capacity in activities of daily living and at work, as well as their general wellbeing and quality of life. Pain between the buttock and lower edge of the ribs is referred to as low back pain, and it can be classified as acute, sub-acute, or chronic depending on how long it lasts. Acute pain lasts less than four weeks, sub-acute pain lasts more than four but less than twelve weeks and if pain lasts for more than 12 weeks it is chronic LBP. The prevalence of chronic low back pain is steadily rising in today's aging population. Around 80% of the population experience spinal pain sooner or later in life.. The intervertebral disc absorbs physical shock to the backbone; it is composed of two dissimilar tissue layers, an inner layer called the nucleus pulposus and an external layer called the annulus fibrosis. Muscle spasm refers to sustained contraction of a muscle and the increase in chronic tension contributes to pain.
NCT05029726
Opioid overuse is a widespread public health crisis in the United States with increasing rates of addiction and overdose deaths from prescription opioids. Reducing the need for opiate analgesics in the post-operative setting has become a high priority in minimizing long-term opioid use in surgical patients. This study will serve to demonstrate the efficacy of the addition of regional analgesic techniques in reducing post-operative opioid requirements in patients undergoing common lumbar spinal surgical procedures.
NCT07400068
This prospective observational study aims to evaluate the clinical outcomes of patients with single-level lumbar disc herniation who undergo routine percutaneous laser disc decompression (PLDD). In routine clinical practice, some patients receive an additional transforaminal anterior epidural steroid injection during the same session without an extra puncture. This study will prospectively follow patients who receive PLDD alone and those who receive PLDD combined with epidural steroid injection. Pain intensity, functional status, analgesic use, need for additional interventions, and complications will be assessed over time. The results may help to clarify whether adding epidural steroid injection to PLDD improves clinical outcomes in patients with lumbar disc herniation.
NCT07393750
To compare between high-power laser versus pulsed electromagnetic therapy on pain and Hoffman reflex in lumbar radiculopathy.
NCT07367191
Transforaminal epidural steroid injection (TFESI) is a commonly used minimally invasive procedure for the treatment of lumbar radicular pain secondary to disc herniation. Although TFESI has been shown to provide significant pain relief in a substantial proportion of patients, the onset, duration, and temporal pattern of pain relief after the procedure vary considerably among individuals. The relationship between early pain response patterns and long-term treatment success remains poorly understood. This prospective observational study aims to evaluate whether temporal changes in pain intensity following TFESI, particularly during the early post-procedural period, are associated with clinical treatment success at mid- and long-term follow-up. Pain intensity will be assessed using the Numeric Rating Scale (NRS) at predefined time points following the procedure, and treatment success will be defined as a ≥50% reduction in NRS score compared with baseline.
NCT03733626
The objective of this study is to perform a prospective, randomized, controlled clinical trial to compare radiographic fusion rates and patient reported outcomes, including pain and function preoperatively and postoperatively, using Depuy ViviGen® Cellular Bone Matrix mixed with cortical/cancellous allograft in conjunction with an approved Depuy Synthes pedicle screw system compared to autograft mixed with cortical/cancellous allograft in conjunction with the same DePuy Synthes pedicle screw system used for a one or two - level posterolateral lumbar fusion.
NCT06990113
to investigate The Efficacy of three-dimensional lumbar myofascial release with motor control training on back perception and pain in lumbar radiculopathy Patients with lumbar radiculopathy demonstrate impairments in function and range of motion to deficits in patient's quality of life.
NCT03060434
The objective of this prospective controlled crossover study is to evaluate the efficacy and safety of pentoxifylline per os (800 mg daily) in the management of lumbar radiculopathy
NCT06076408
The aim of this study is to compare the effects of Sustained Natural Apophyseal Glides with and without Pilates on pain, range of motion and disability in patients with lumbar Disc Bulge.
NCT06846970
The aim of this study is to investigate the effects of adding balneotherapy to the conventional physical therapy program on neuropathic pain, disability, daily living activities, and sleep quality in patients with chronic lumbar radiculopathy.
NCT04540068
Rationale: Treatment with transforaminal epidural injections is part of usual care in patients suffering from lumbar radiculopathy. However, not all patients experience a satisfactory result from this treatment and it is unclear what percentage of patients responds well and if any clinical or radiological factors exist that predict a positive response. Objectives: Primary: to develop a model based on demographic, clinical and radiological parameters for prediction of treatment success after TEI Secondary: to estimate the short-term efficacy of TEI in patients with LDH and spinal stenosis based on pain, functionality and perceived recovery scores, to determine the correlation between clinical and radiological baseline parameters and physical and psychological patient outcome measures, to determine the rate of additional injections and rate of surgery after treatment with TEI, to determine the short-term (cost)effectiveness of TEI on physical and psychological patient outcome measures, and to determine the rate of complications associated with TEI Study design: Prospective cohort study Study population: Patients that are scheduled for TEI as part of usual care suffering from a new episode of lumbar radiculopathy Main study parameters/endpoints: leg and back pain scores at baseline, 30 minutes, 2 and 6 weeks after treatment. ODI, HADS, Quality of Life and PCI at baseline, 2 and 6 weeks after treatment. Perceived recovery at 2 and 6 weeks after treatment. Usage of healthcare at baseline, 2 and 6 weeks after treatment.