NCT03317275

Brief Summary

Prior to the injection, the facet joints have to be defined according to standard radiological techniques (e.g. MRI and physical correlation). Patients are then sent to 18F-Fluoride-PET/MRI imaging, in order to localize facet joints with increased uptake. Facet joints to be injected are again defined according to the location(s) of highest uptake as demonstrated by 18F-Fluoride-PET/MRI. The defined injection sites before and after PET/MRI are compared. In equal defined injection sites, patients are sent for infiltration as scheduled, otherwise patients are randomized into two groups. One group will undergo facet injection(s) according to the 18F-Fluoride-PET/MRI result, with standard injections performed under CT-guidance by the radiology department of the study site. The control group will undergo facet injections blinded to the 18F-Fluoride-PET/MRI results, but based on current standard clinical practise (MRI and clinical correlation). The patients are asked to complete a validated pain and function questionnaire immediately before the facet joint injection, at 15 minutes, 1 day, 1 week and 1 month after the injection, as performed routinely in our institution. The purpose of this study is to prospectively evaluate the value of 18F-Fluoride-PET/MRI imaging in patients with low back pain with evidence of painful facet joint arthropathy, which would potentially benefit from facet joint injections.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started May 2017

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

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

Study Start

First participant enrolled

May 26, 2017

Completed
12 days until next milestone

First Submitted

Initial submission to the registry

June 7, 2017

Completed
5 months until next milestone

First Posted

Study publicly available on registry

October 23, 2017

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 24, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 24, 2020

Completed
Last Updated

June 9, 2020

Status Verified

June 1, 2020

Enrollment Period

2.9 years

First QC Date

June 7, 2017

Last Update Submit

June 8, 2020

Conditions

Outcome Measures

Primary Outcomes (1)

  • pain reduction

    reduction of pain after facet joint injection assessed by visual analogue scale (VAS)

    VAS immediately before the facet joint injection, at 15 minutes, 1 day, 1 week and 1 month after the injection

Secondary Outcomes (2)

  • location of uptake in 18F-Fluoride-PET/MRI

    40 +/- 7 days post injection

  • quantity of uptake in 18F-Fluoride-PET/MRI

    40 +/- 7 days post injection

Study Arms (2)

injection based on 18F-Fluoride-PET/MRI

EXPERIMENTAL

One group will undergo facet injection(s) according to the 18F-Fluoride-PET/MRI result, with standard injections performed under CT-guidance. The Pain assessment by VAS immediately before the facet joint injection, at 15 minutes, 1 day, 1 week and 1 month after the injection, as performed routinely in our institution.

Device: 18F-Fluoride-PET/MRIProcedure: facet injectionOther: pain assessment by VAS

injection based on clinical practise

ACTIVE COMPARATOR

The control group will undergo facet injections blinded to the 18F-Fluoride-PET/MRI results, but based on current standard clinical practise (MRI and clinical correlation). Pain assessment by VAS immediately before the facet joint injection, at 15 minutes, 1 day, 1 week and 1 month after the injection, as performed routinely in our institution.

Device: 18F-Fluoride-PET/MRIProcedure: facet injectionOther: pain assessment by VAS

Interventions

facet joint injection guided by the anatomical localization of causative structures by PET/MRI compared to standard assessment techniques.

injection based on 18F-Fluoride-PET/MRIinjection based on clinical practise

facet joint local anesthetic and corticosteroid injection according to the 18F-Fluoride-PET/MRI result or based on current standard clinical practise (MRI and clinical correlation) respectively

injection based on 18F-Fluoride-PET/MRIinjection based on clinical practise

VAS questionnaire immediately before the facet joint injection, at 15 minutes, 1 day, 1 week and 1 month after the injection, as performed routinely in our institution.

injection based on 18F-Fluoride-PET/MRIinjection based on clinical practise

Eligibility Criteria

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

You may qualify if:

  • Patients over 18 years old with low back pain who have failed conservative management in the primary care setting, namely, analgesia and physical therapy.
  • Imaging evidence (e.g. MRI) of facet joint degeneration, such as facet hypertrophy, subchondral sclerosis, and joint space narrowing.
  • Obtained informed consent

You may not qualify if:

  • had undergone prior spinal surgery or prior facet joint injections or
  • had other spinal abnormalities (benign or malignant tumors, congenital defects, isthmic spondylolisthesis) or
  • are unable to tolerate PET/MRI imaging
  • are pregnant or nursing.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University Clinic Balgrist

Zurich, Canton of Zurich, 8008, Switzerland

Location

MeSH Terms

Conditions

Back Pain

Condition Hierarchy (Ancestors)

PainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Mazda Farshad, PD Dr. med.

    Balgrist University Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Model Details: Prospective randomised cohort study, partial blinded
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 7, 2017

First Posted

October 23, 2017

Study Start

May 26, 2017

Primary Completion

April 24, 2020

Study Completion

April 24, 2020

Last Updated

June 9, 2020

Record last verified: 2020-06

Locations