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The primary objective of this study is to compare the improvement in subject-reported clinical outcomes for Regenexx PL-Disc vs. steroid epidural for treatment of lumbar radiculopathy, from baseline to 3 months, with continued evaluation of efficacy and durability up to 12 months.
Secondary objectives include incidence of post-operative complications, adverse events, re-injections, and surgical intervention; change in pain score and use of pain medications.
Prospective, single-blinded, randomized, controlled to include 25 subjects treated with Regenexx PL-Disc and 25 subjects treated with steroid epidural injection with the steroid epidural group crossing over to the PL-Disc injection group at 3 months.
Subjects will have symptoms consistent with lumbar radiculopathy confirmed by physical examination.
Subjects will be enrolled within 60 days prior to injection and take part in follow-up visits for one year following treatment. A preoperative visit will occur at the time of enrollment; follow-up visits will occur at the clinical site at 6 weeks, 3 months, 6 months and 12 months post injection. Subjects will remain blinded to the treatment allocation through at least the 3 month primary endpoint. Control subjects not improving after the 3 month visit will be unblinded and given the opportunity to cross-over to the PL-Disc group.
Subjects will complete the study following the 1 year follow-up visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regenexx PL-Disc | Active Comparator | Injection of Regenexx PL-Disc into the epidural space once a week for two weeks. |
|
| Steroid Epidural | Active Comparator | Injection of steroid into the epidural space once a week for two weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regenexx PL-Disc | Procedure | Injection into the epidural space under image guidance of autologous, concentrated peripheral blood based platelet mix combined with a nanogram dose of corticosteroid. |
| Measure | Description | Time Frame |
|---|---|---|
| Oswestry Disability Index Change from Baseline | The primary endpoint for this study is the difference between treatment groups in the within patient mean change from baseline to 3 months in Oswestry Disability Index (ODI) scores. | Change from baseline to 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Functional Rating Index Scores | Difference between treatment groups in mean Functional Rating Index (FRI) scores at each follow-up timepoint. | 6 weeks, 3 months, 6 months, 12 months |
| Mean ODI scores |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christopher Centeno, MD | Centeno-Schultz Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centeno-Schultz Clinic | Broomfield | Colorado | 80021 | United States |
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| ID | Term |
|---|---|
| D011843 | Radiculopathy |
| D007405 | Intervertebral Disc Displacement |
| D055959 | Intervertebral Disc Degeneration |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D013122 | Spinal Diseases |
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| Steroid Epidural | Procedure | Injection into the epidural space under image guidance of 3 mg of betamethasone. |
|
Difference between treatment groups in mean ODI scores at each follow-up timepoint
| 6 weeks, 3 months, 6 months, 12 months |
| Mean Pain Scales | Difference between treatment groups in mean 0-10 pain scales at each follow-up timepoint | 6 weeks, 3 months, 6 months, 12 months |
| Incidence of Complications and Adverse Events | Incidence of post-operative complications and adverse events between treatment groups. | 12 months |
| Incidence of re-injection/re-operation | Incidence of re-injection and surgical operation between treatment groups. | 12 months |
| Use of pain medications | Difference between treatment groups in use of pain medications at each follow-up timepoint | 6 weeks, 3 months, 6 months, 12 months |
| Time to Resolution of Complications and Adverse Events | Time to resolution of post-operative complications and adverse events between treatment groups. | 12 months |
| Time to re-injection/re-operation | Time to re-injection and surgical operation between treatment groups. | 12 months |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006547 | Hernia |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |