CClinicalTrials.gg
Status unknownNCT04803149Lumbar CvSUpdated Jun 30, 2022

Cooled RFA vs Conventional RFA to Manage Chronic Facetogenic Low Back Pain

An interventional study of Cooled Radiofrequency and Conventional Radiofrequency in Chronic Low-back Pain, sponsored by Avanos Medical. Status unknown at 10 sites in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2022-06-30.

Sponsored by Avanos Medical · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Jun 2022), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
79
Allocation
Randomized
Ages
21 Years and older
Sex
All
01

Study summary

This study is being conducted to assess the relative effectiveness of radiofrequency neurotomy in subjects with chronic axial low back pain originating in the lumbar facet joints using the COOLIEF* Cooled Radiofrequency Probe as compared to the same procedure conducted using a Standard Radiofrequency Probe.

Read the detailed description

This is a prospective, multi-center, randomized, single-blind comparison study examining the outcomes of subjects with chronic axial low back pain that originates in the lumbar facet joints undergoing a procedure to create a radiofrequency lesion in the medial branch nerves with either Cooled Radiofrequency Ablation (CRFA) or Conventional (Standard) Radiofrequency Ablation (SRFA). Approximately 188 participants from approximately 15 sites will be enrolled into this study, with subjects undergoing either CRFA or SRFA in a 1:1 randomization scheme. Follow-up will be conducted for 12 months post-treatment, with the primary endpoint being completed at month 6. Pain, overall outcome, quality of life, pain medication use, and adverse events will be compared between the two treatment groups to determine success.

02

Conditions studied

  • Chronic Low-back Pain

Keywords

  • Pain Management
  • Lumbar facet syndrome
  • Radiofrequency Ablation
  • Low Back
  • Medial Branch Nerves
03

In context

Back Pain

2,373 studies on the registry are indexed under Back Pain; 284 are open to participants now.

This study's enrollment of 79 is above the median of 60 across 1,941 interventional studies indexed under Back Pain.

Browse Back Pain studies →

Lead sponsor

Avanos Medical is the lead sponsor of 5 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age ≥ 21 years
  2. Able to understand the informed consent form and provide written informed consent and able to complete outcome measures.
  3. Subjects who have chronic axial (non-radicular) low back pain (at least 3 months) attributed to bilateral L4/L5, L5/S1 lumbar facet joint arthropathy based on clinical evaluation (paraspinal tenderness in the absence of signs and symptoms suggestive of focal neurological deficits) despite conservative treatments, including activity modification, home exercise, protective weight bearing, and/or analgesics (for example, acetaminophen or non-steroidal anti-inflammatory drugs [NSAIDs]).
  4. Positive response to dual diagnostic medial branch blocks (defined as a decrease in numeric pain scores of at least 80% for a min of 3 hours for bupivacaine and minimum of 2 hours for lidocaine) using 0.5mL or less of 0.5% bupivacaine and 2% lidocaine, on respective encounters on separate days, at each of the appropriate medial branches.
  5. Usual/Average Pain ≥ 6 on an 11-point NRS scale.
  6. Analgesics including membrane stabilizers such as Neurontin (gabapentin) and antidepressants for pain, such as Cymbalta (duloxetine), must be clinically stable (defined as stable dosage for ≥ 6 weeks prior to the screening visit) and shall not change during the study without approval of the investigator.
  7. Agree to see one physician (study physician) for back pain during the study period.
  8. Subjects of child bearing potential must be willing to utilize double barrier contraceptive method for duration of participation.
  9. Willingness to comply with the requirements of this protocol for the full duration of the study.

Exclusion criteria

Exclusion Criteria:

  1. Evidence of inflammatory arthritis (example, rheumatoid arthritis) or other systemic condition (example; gout, fibromyalgia, MS, Lupus, etc.) that could cause pain.
  2. Focal neurologic signs or symptoms.
  3. Spinal pathology that may impede recovery such as spina bifida occulta, grade II or higher spondylolisthesis at an affected joint or adjacent level, or significant lumbar scoliosis (sagittal vertical axis angle >5 degrees or Cobb Angle >10 degrees).
  4. Suspected mechanical instability based on flexion/extension and/or films at the proposed treatment levels
  5. History of prior lumbar fusion or previous lumbar back surgery at the intended treatment levels.
  6. Progressive motor deficit, and/or clinical signs of cauda equina or polyradiculopathy.
  7. Radiologic evidence of a symptomatic herniated disc or nerve root impingement.
  8. Symptomatic moderate or severe foramina or central canal stenosis demonstrating radicular symptoms or neurogenic claudication.
  9. Evidence of neuropathic pain affecting the lower back.
  10. Intra-articular steroid injection at target levels within 90 days from randomization.
  11. Platelet rich plasma (PRP) or stem cells at target levels within 180 days from randomization.
  12. Prior lumbar radiofrequency neurotomy of the L3/L4, L4/L5 medial branches and/or L5/S1dorsal ramus.
  13. Body mass index (BMI) > 40 kg/m2
  14. Extremely thin patients and those with minimal subcutaneous tissue thickness that would not accommodate a radiofrequency lesion of up to 14 mm in diameter to limit the risk of skin burns.
  15. Active joint infection or systemic or localized infection at needle entry sites (subject may be considered for inclusion once infection is resolved).
  16. Pending or active compensation claim, litigation, or disability remuneration (e.g. disability, worker's compensation, auto injury in litigation or pending litigation).
  17. Pregnant, nursing or intent of becoming pregnant during the study period
  18. Chronic pain associated with significant psychosocial dysfunction.
  19. Poorly controlled severe psychiatric illness or ongoing psychological barriers to recovery, as determined by the investigator.
  20. Allergies to any of the medications to be used during the procedures
  21. History of uncontrolled coagulopathy, ongoing coagulation treatment that cannot be safely interrupted for procedure, or unexplained or uncontrollable bleeding that is uncorrectable.
  22. Identifiable anatomical variability that would materially alter the procedure as described in the protocol.
  23. Within the preceding 2 years, subject has suffered from active narcotic addiction, substance, or alcohol abuse.
  24. Current prescribed opioid medications greater than 50 morphine equivalent daily opioid dose.
  25. Uncontrolled immunosuppression (e.g. AIDS, cancer, diabetes, etc.).
  26. Subject currently implanted with pacemaker, stimulator or defibrillator.
  27. Participating in another clinical trial/investigation which included therapeutic treatment within 30 days prior to signing informed consent.
  28. Subject unwilling or unable to comply with follow up schedule, protocol requirements or procedures.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
79 participants (actual)

Study arms

  • Experimental
    Cooled Radiofrequency

    Cooled radiofrequency energy will be delivered to target medial branch nerves in the lower back to reduce pain

    Device: Cooled Radiofrequency

  • Active comparator
    Conventional Radiofrequency

    Conventional radiofrequency energy will be delivered to target medial branch nerves in the lower back to reduce pain

    Device: Conventional Radiofrequency

Interventions

  • DeviceCooled Radiofrequency

    Delivery of energy to ablate sensory nerves via cooled radiofrequency probe

    Also known as: Coolief

  • DeviceConventional Radiofrequency

    Delivery of energy to ablate sensory nerves via standard or conventional radiofrequency probe

    Also known as: Standard Radiofrequency

06

What researchers measure

Primary outcomes

  1. The proportion of subjects whose back pain is reduced by ≥ 50 percent based on the NRS scale at 6 Months

    The NRS is an 11-point scale (0 points to 10 points), where 0 points equals "no pain" and 10 points equals "worst pain". There are no sub-scales.

    Time frame: 6 months

  2. Proportion of subjects experiencing adverse events through 6-months

    Time frame: 6 months

Secondary outcomes

  1. The mean change in SF-36 Physical Functioning (PF) score from baseline to the 6-month visit

    Short Form 36-PF - score range = 0 - 100. "0" corresponds to "greatest disability" and "100" indicates "no disability". The means of these scores and their respective standard deviations are reported for each study group

    Time frame: 6 months

  2. The mean change in Oswestry Disability Index (ODI) score from baseline to the 6-month visit

    ODI - score range = 0 - 100. "0" corresponds to "no disability" and "100" indicates the "maximum disability possible". The means of these scores and their respective standard deviations are reported for each study group

    Time frame: 6 months

  3. The measured Global Perceived Effect scale at the 6-month visit

    The Global Perceived Effect is a 7-point scale: 1 point = "worst ever", 2 points = "much worse", 3 points = "worse", 4 points = "not improved but not worse", 5 points = "improved", 6 points = "much improved", 7 points = "best ever". There are no sub-scales.

    Time frame: 6 months

  4. The mean change in EQ-5D-5L score from baseline to the 6-month visit

    This outcome instrument is composed two components. The first component consists of five sub-scales containing five questions each. The point range for each sub-scale is from 1 to 5, with "1" indicating the best study subject condition and "5" indicating the worst study subject condition. Thus, the minimum and maximum scores per sub-scale are 1 and 5, respectively, and such scores for the entire instrument are 5 (best study subject condition) and 25 (worst study subject condition). The sub-scale topics are: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. The second component, EQ-Visual Analog Scale (VAS), has a score range of 0 - 100. "0" corresponds to the "worst imaginable health state" and "100" indicates the "best imaginable health state". The means of these scores and their respective standard deviations are reported for each study group.

    Time frame: 6 months

  5. The proportion of subjects requiring additional intervention for their back pain during the 6-month period

    Time frame: 6 months

Other outcomes

  1. The proportion of subjects whose back pain is reduced by ≥ 50 percent based on the NRS scale at 12 Months

    The NRS is an 11-point scale (0 points to 10 points), where 0 points equals "no pain" and 10 points equals "worst pain". There are no sub-scales.

    Time frame: 12 months

  2. Proportion of subjects experiencing adverse events through 12 months

    Time frame: 12 months

  3. The mean change in SF-36 Physical Functioning (PF) score from baseline to the 12-month visit

    Short Form 36-PF - score range = 0 - 100. "0" corresponds to "greatest disability" and "100" indicates "no disability". The means of these scores and their respective standard deviations are reported for each study group

    Time frame: 12 months

  4. The mean change in Oswestry Disability Index (ODI) score from baseline to the 12-month visit

    ODI - score range = 0 - 100. "0" corresponds to "no disability" and "100" indicates the "maximum disability possible". The means of these scores and their respective standard deviations are reported for each study group

    Time frame: 12 months

  5. The measured Global Perceived Effect scale at the 12-month visit

    The Global Perceived Effect is a 7-point scale: 1 point = "worst ever", 2 points = "much worse", 3 points = "worse", 4 points = "not improved but not worse", 5 points = "improved", 6 points = "much improved", 7 points = "best ever". There are no sub-scales.

    Time frame: 12 months

  6. The mean change in EQ-5D-5L score from baseline to the 12-month visit

    This outcome instrument is composed two components. The first component consists of five sub-scales containing five questions each. The point range for each sub-scale is from 1 to 5, with "1" indicating the best study subject condition and "5" indicating the worst study subject condition. Thus, the minimum and maximum scores per sub-scale are 1 and 5, respectively, and such scores for the entire instrument are 5 (best study subject condition) and 25 (worst study subject condition). The sub-scale topics are: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. The second component, EQ-Visual Analog Scale (VAS), has a score range of 0 - 100. "0" corresponds to the "worst imaginable health state" and "100" indicates the "best imaginable health state". The means of these scores and their respective standard deviations are reported for each study group.

    Time frame: 12 months

  7. The proportion of subjects requiring additional intervention for their back pain during the 12-month period

    Time frame: 12 months

07

Study locations

10 sites
  • International Spine & Pain Performance Center
    Washington, District of Columbia 20006, United States
  • Millennium Pain Center
    Bloomington, Illinois 61704, United States
  • Ochsner Baptist Medical Center
    New Orleans, Louisiana 70115, United States
  • Premier Pain Centers
    Shrewsbury, New Jersey 07702, United States
  • The Center for Clinical Research
    Winston-Salem, North Carolina 27103, United States
  • University Orthopedics Center
    Altoona, Pennsylvania 16602, United States
  • Pain Diagnostics and Interventional Care
    Sewickley, Pennsylvania 15143, United States
  • University Orthopedics Center
    State College, Pennsylvania 16801, United States
  • University of Utah
    Salt Lake City, Utah 84108, United States
  • The Spine and Nerve Centers of St. Francis Hosptial
    Charleston, West Virginia 25301, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 30, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04803149
Lead sponsor
Avanos Medical
Responsible party
Sponsor
First posted
Mar 17, 2021
Start date
Feb 23, 2021
Primary completion
Jan 2023 (estimated)
Completion
Jul 2023 (estimated)
Last update
Jun 30, 2022

Study contacts

David Provenzano
principal investigator · Pain Diagnostics and Interventional Care

Oversight

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

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