CClinicalTrials.gg
RecruitingNCT04540068POTEISSUpdated Mar 12, 2025

Prediction of TEI Success in Sciatica

An observational study in Lumbar Radiculopathy, Lumbar Disc Herniation and Lumbar Spinal Stenosis, sponsored by Eduard Verheijen. Recruiting at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-03-12.

Sponsored by Eduard Verheijen · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
388
Ages
18 Years and older
Sex
All
01

Study summary

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.

Read the detailed description

Data collection schedule Baseline Weeks of follow-up 30 min. Day 4 Week 2 Week 6 Demographic data ✓ NRS leg pain ✓ ✓ ✓ ✓ NRS back pain ✓ ✓ ✓ ✓ ODI ✓ ✓ ✓ HADS ✓ ✓ ✓ QoL VAS ✓ ✓ ✓ PCI ✓ ✓ ✓ Likert score ✓ ✓ Adjuvant therapy ✓ ✓ ✓ TEI data ✓ ✓

02

Conditions studied

  • Lumbar Radiculopathy
  • Lumbar Disc Herniation
  • Lumbar Spinal Stenosis

Keywords

  • Transforaminal Epidural Injection
  • Lumbar spine
  • Prospective cohort study
  • Prediction of success
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients suffering from lumbar radiculopathy due to lumbar disc herniation or spinal stenosis that have a scheduled appointment for treatment with TEI are screened to be candidates for this study. If the patient fulfills the inclusion and exclusion criteria the patient can participate in this study.

Inclusion criteria

  • Diagnosis of unilateral lumbar radiculopathy secondary to LDH or one-level spinal stenosis
  • Diagnosis supported by magnetic resonance imaging (MRI) findings
  • Scheduled appointment for TEI
  • Access to e-mail
  • Signed informed consent

Exclusion criteria

Exclusion Criteria:

  • Diagnosis of unilateral lumbar radiculopathy secondary to LDH or one-level spinal stenosis
  • Age under 18 years
  • Severe multisegmental spinal disease
  • Anatomical abnormalities that may complicate the procedure technically (e.g. severe scoliosis)
  • Active malignancy or infectious disease
  • Use of immunosuppressive drugs
  • Use of systemic corticosteroids in preceding 3 months
  • Previous treatment with TEI for current episode of lumbar radiculopathy
  • History of lower back surgery at the same lumbar level
  • Circumstances that prevent treatment with TEI (e.g. use of anticoagulants that cannot be temporarily discontinued, allergy against steroids or local anaesthetic)
  • Pregnancy
  • Major language barrier
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
388 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients with Lumbar Disc Herniation

    Patients with a lumbar disc herniation on MRI and consistent with clinical findings are screened if they have an appointment at the pain clinic for treatment with a transforaminal epidural injection.

    Drug: Transforaminal Epidural Injection

  • Patients with Lumbar Spinal Stenosis

    Patients with a lumbar spinal stenosis on MRI and consistent with clinical findings are screened if they have an appointment at the pain clinic for treatment with a transforaminal epidural injection.

    Drug: Transforaminal Epidural Injection

Interventions

  • DrugTransforaminal Epidural Injection

    Injections above L3 will contain 1,5 ml lidocaine 1% and 10 mg dexamethasone and injections at L3 or below will contain 1,5 ml lidocaine 2% and 40mg methylprednisolone acetate in accordance with current Dutch anesthesiologic guidelines for usual care.

    Also known as: Transforaminal Epidural Steroid Injection

05

What researchers measure

Primary outcomes

  1. Numerical Rating Scale Leg Pain

    The NRS score for leg pain

    Time frame: 2 weeks

Secondary outcomes

  1. Numerical Rating Scale Leg Pain

    The NRS score for leg pain

    Time frame: 30 minutes after treatment

  2. Numerical Rating Scale Leg Pain

    The NRS score for leg pain

    Time frame: 6 weeks

  3. Numerical Rating Scale Back Pain

    The NRS score for back pain

    Time frame: 30 minutes after treatment

  4. Numerical Rating Scale Back Pain

    The NRS score for back pain

    Time frame: 2 weeks

  5. Numerical Rating Scale Back Pain

    The NRS score for back pain

    Time frame: 6 weeks

  6. Oswestry Disability Index

    The ODI score for functionality

    Time frame: 2 weeks

  7. Oswestry Disability Index

    The ODI score for functionality

    Time frame: 6 weeks

  8. Global Perceived Effect

    The degree of patient satisfaction from experienced recovery on a Likert scale

    Time frame: 2 weeks

  9. Global Perceived Effect

    The degree of patient satisfaction from experienced recovery on a Likert scale

    Time frame: 6 weeks

  10. Hospital Anxiety and Depression Scale

    The HADS score for assessment of anxiety and depression

    Time frame: 2 weeks

  11. Hospital Anxiety and Depression Scale

    The HADS score for assessment of anxiety and depression

    Time frame: 6 weeks

  12. Pain Coping Inventory

    Assessment of the pain coping mechanisms of the patient

    Time frame: 2 weeks

  13. Pain Coping Inventory

    Assessment of the pain coping mechanisms of the patient

    Time frame: 6 weeks

  14. Visual Analogue Scale Quality of Life

    The VAS for assessment of Quality of Life

    Time frame: 2 weeks

  15. Visual Analogue Scale Quality of Life

    The VAS for assessment of Quality of Life

    Time frame: 6 weeks

  16. Use of pain medication and physical therapy

    Use of pain medication and physical therapy

    Time frame: 2 weeks

  17. Use of pain medication and physical therapy

    Use of pain medication and physical therapy

    Time frame: 6 weeks

06

Study locations

1 of 1 sites recruiting
  • Spaarne Gasthuis
    Haarlem, Netherlands
    • Carmen Vleggeert-Lankamp, M.D. Ph.D · Contact
    Recruiting
07

References and documents

Publications

  • Vroomen PC, de Krom MC, Knottnerus JA. Predicting the outcome of sciatica at short-term follow-up. Br J Gen Pract. 2002 Feb;52(475):119-23. PubMed 11887877 ↗
  • Sencan S, Celenlioglu AE, Asadov R, Gunduz OH. Predictive factors for treatment success of transforaminal epidural steroid injection in lumbar disc herniation-induced sciatica. Turk J Med Sci. 2020 Feb 13;50(1):126-131. doi: 10.3906/sag-1908-167. PubMed 31742372 ↗
  • Billy GG, Lin J, Gao M, Chow MX. Predictive Factors of the Effectiveness of Caudal Epidural Steroid Injections in Managing Patients With Chronic Low Back Pain and Radiculopathy. Clin Spine Surg. 2017 Jul;30(6):E833-E838. doi: 10.1097/BSD.0000000000000454. PubMed 27764056 ↗
  • Lee JW, Kim SH, Lee IS, Choi JA, Choi JY, Hong SH, Kang HS. Therapeutic effect and outcome predictors of sciatica treated using transforaminal epidural steroid injection. AJR Am J Roentgenol. 2006 Dec;187(6):1427-31. doi: 10.2214/AJR.05.1727. PubMed 17114531 ↗
  • McCormick Z, Cushman D, Casey E, Garvan C, Kennedy DJ, Plastaras C. Factors associated with pain reduction after transforaminal epidural steroid injection for lumbosacral radicular pain. Arch Phys Med Rehabil. 2014 Dec;95(12):2350-6. doi: 10.1016/j.apmr.2014.07.404. Epub 2014 Aug 7. PubMed 25108099 ↗
  • Cyteval C, Fescquet N, Thomas E, Decoux E, Blotman F, Taourel P. Predictive factors of efficacy of periradicular corticosteroid injections for lumbar radiculopathy. AJNR Am J Neuroradiol. 2006 May;27(5):978-82. PubMed 16687527 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT04540068
Lead sponsor
Eduard Verheijen
Collaborators
Spaarne Gasthuis
Responsible party
Eduard Verheijen (Bsc., Leiden University Medical Center) — Sponsor-investigator
First posted
Sep 7, 2020
Start date
Nov 15, 2020
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Mar 12, 2025

Study contacts

Eduard JA Verheijen, MD
Contact
e.j.a.verheijen@lumc.nl
+3171526746
Carmen LA Vleggeert-Lankamp, MD, PhD
Contact
c.l.a.vleggeert-lankamp@lumc.nl
+31715262093
Carmen LA Vleggeert-Lankamp, MD, PhD
principal investigator · Leiden University Medical Centre / Spaarne Gasthuis

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion