NCT02112474

Brief Summary

Electrical stimulation of the spinal cord (Spinal Cord Stimulation or SCS) for pain relief has been used for decades. It is used most commonly in patients with chronic neuropathic leg pain, after spinal surgery. Conventional neurostimulation is applied in frequencies of 30 to 60 Hertz (Hz) and perceptible paraesthesias are felt. Stimulation using higher frequencies with sub perception paraesthesias has recently challenged the conventional form of neurostimulation.The high frequency stimulation appears to show better pain relief for both back and limb pain in comparison to low frequency SCS, and may also to be effective in some subjects who did not respond to low frequency SCS.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
30

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Nov 2014

Longer than P75 for not_applicable

Geographic Reach
1 country

5 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 25, 2014

Completed
20 days until next milestone

First Posted

Study publicly available on registry

April 14, 2014

Completed
7 months until next milestone

Study Start

First participant enrolled

November 13, 2014

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 17, 2017

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

November 30, 2018

Completed
Last Updated

November 30, 2020

Status Verified

November 1, 2020

Enrollment Period

3 years

First QC Date

March 25, 2014

Last Update Submit

November 26, 2020

Conditions

Keywords

Failed Back Surgery SyndromeNeuropathic painLeg PainChronic PainSpinal Cord StimulationNeurostimulation

Outcome Measures

Primary Outcomes (1)

  • Visual Analog Pain Scores (VAS)

    0mm to 10mm line scale, where higher score is better, measured 4 times a day at 09:00, 15:00, 21:00 and a nightscore measured first thing in the morning

    24 days

Secondary Outcomes (7)

  • Visual Analog Pain scores (VAS)

    12 months

  • EuroQoL 5Dimensions-3Levels

    1 month, 12 months

  • Short Form-36

    1 month, 12 months

  • Sleep questionnaire

    1 month, 12 months

  • GPES

    1 month, 12 months

  • +2 more secondary outcomes

Study Arms (2)

Spinal Cord Stimulation Group 1

EXPERIMENTAL

9 days of spinal cord stimulation at 30 Hertz and perceptible paraesthesias

Device: Spinal Cord StimulationDevice: Group 1

Spinal Cord Stimulation Group 2

EXPERIMENTAL

9 days of spinal cord stimulation with 1000 Hertz and sub-perception paraesthesias

Device: Spinal Cord StimulationDevice: Group 2

Interventions

Crossover design whereby subjects will undergo Spinal Cord Stimulation in two arms: low frequency stimulation and high frequency stimulation

Spinal Cord Stimulation Group 1Spinal Cord Stimulation Group 2
Group 1DEVICE

9 days of spinal cord stimulation at 30 Hertz and perceptible paraesthesias

Spinal Cord Stimulation Group 1
Group 2DEVICE

9 days of spinal cord stimulation with 1000 Hertz and sub-perception paraesthesias

Spinal Cord Stimulation Group 2

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male/female, 18 years to 70 years
  • Chronic, persistent, refractory, unilateral neuropathic limb pain, as a result of spinal surgery
  • Failed conservative treatments for chronic pain including but not limited to pharmacological therapy, physical therapy and minimally interventional pain procedures for chronic pain
  • Pain radiating in the leg, following segments L4 and/or L5 and/or S1 for at least 6 months
  • Minimum baseline pain intensity as assessed by VAS of ≥ 50mm on 100mm scale in the primary pain area
  • Subject is able and willing to provide informed consent
  • Subject is able and willing to comply with the protocol and follow-up schedule
  • Subject has been included for implantation according to standard criteria from the Dutch Neuromodulation Society

You may not qualify if:

  • Back pain component of more than 20% or VAS \> 40mm on 100mm scale
  • Bilateral limb pain
  • Subjects with a previous SCS implantation.
  • Changes in pain medication in the 2 months preceding the trial period;
  • Expected inability of subjects to correctly operate the neurostimulation system
  • Presence of any other clinically significant or disabling chronic pain condition -eg. hip arthrosis, rheumatoid arthritis, fibromyalgia, etc.
  • History of coagulation disorders, lupus erythematosus, diabetes mellitus, or morbus Bechterew
  • Symptoms or proof of any malignant disease
  • Current use of medicines affecting coagulation which cannot be temporarily stopped
  • Evidence of an active disruptive psychiatric disorder or other known condition significant enough to impact the perception of pain, compliance to intervention and/or ability to evaluate treatment outcome as determined by the investigator
  • Life expectancy of less than 1 year
  • Existing or planned pregnancy in the trial period
  • BMI \>20 and \<35 - a minimum and maximum BMI limit are imposed due to the technical difficulties and risk of complications in underweight or morbidly obese subjects.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Rijnstate Hospital

Velp, Gelderland, 883 AZ, Netherlands

Location

Medisch Centrum Alkmaar

Alkmaar, North Holland, 1815 JD, Netherlands

Location

Academic Medical Center

Amsterdam, North Holland, 1105 AZ, Netherlands

Location

Alrijne Hospital

Leiderdorp, South Holland, 2353 GA, Netherlands

Location

Diakonessenhuis

Zeist, Utrecht, 3700 BA, Netherlands

Location

Related Publications (1)

  • Breel J, Wille F, Wensing AGCL, Kallewaard JW, Pelleboer H, Zuidema X, Burger K, de Graaf S, Hollmann MW. A Comparison of 1000 Hz to 30 Hz Spinal Cord Stimulation Strategies in Patients with Unilateral Neuropathic Leg Pain Due to Failed Back Surgery Syndrome: A Multicenter, Randomized, Double-Blinded, Crossover Clinical Study (HALO). Pain Ther. 2021 Dec;10(2):1189-1202. doi: 10.1007/s40122-021-00268-7. Epub 2021 Jun 6.

MeSH Terms

Conditions

Failed Back Surgery SyndromeNeuralgiaChronic Pain

Interventions

Spinal Cord Stimulation

Condition Hierarchy (Ancestors)

Postoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsBack PainPainNeurologic ManifestationsSigns and SymptomsPeripheral Nervous System DiseasesNeuromuscular DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsPhysical Therapy ModalitiesRehabilitation

Study Officials

  • Markus W Hollmann, MD, PhD

    Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

    STUDY CHAIR
  • Frank Wille, MD

    Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

    PRINCIPAL INVESTIGATOR
  • Jennifer S Breel, MPA,MSc.

    Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Study Investigator

Study Record Dates

First Submitted

March 25, 2014

First Posted

April 14, 2014

Study Start

November 13, 2014

Primary Completion

November 17, 2017

Study Completion

November 30, 2018

Last Updated

November 30, 2020

Record last verified: 2020-11

Locations