ClinicalTrials.gg
RecruitingNCT06477094Updated Sep 10, 2026

RFA Using Multi-Tined Electrodes vs.Traditional Electrodes for Lumbar Spondylosis

An interventional study of Stratus Nimbus Electrosurgical RF Multi-Tined Expandable Electrode and Stryker Venom Radiofrequency Cannula in Lumbar Spondylosis, sponsored by University of Arkansas. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by University of Arkansas · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2024; still recruiting 2 years 3 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
25
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Spondylosis is an anatomical defect of the small facet joints between the spinal vertebrae often due to load bearing and mechanical wear. It is a major contributor to lower back pain. The current standard of care in patients diagnosed with spondylosis in the lower back is to perform a radiofrequency ablation (RFA) of the lumbar medial branch nerves which carry the pain signals from that region to the brain. RFA accomplishes this by using radio waves transmitted through inserted electrodes. This leads to a temporary lesion or "burn"; stopping the pain signals from being transmitted as as well as changing the pain signals themselves. The electrodes themselves do not heat up but instead cause ions in the surrounding tissue to vibrate and heat up. When performing the procedure at the UAMS pain clinic, one can use the Stryker system with a single electrode end which protrudes out of the cannula or the Stratus Nimbus electrode with two prongs which expand in a "V"; formation along the sides of the cannula. While testing in chicken tissue shows that the latter electrode type produces a larger lesion size, anecdotal evidence suggests that it may lead to longer term pain relief. As such, the choice is currently left up to physician preference as both are FDA approved for use in this condition. This study is trying to assess if the larger lesion size results in a reduction in impairment of activities of daily living due to pain measured by the patient-reported PROMIS (Patient Reported Measurement Information System)-29 questionnaire. The PROMIS-29 is given to all patients who are seen in the UAMS Pain Clinic at initial and follow-up visits. In this study we would like to randomize what electrode and cannula set is used in RFA for patient's who are already going to be receiving the procedure for treatment for their spondylosis. The study team would then compare the PROMIS outcomes between cases that used the Stryker and Stratus Nimbus electrodes at 1,3,6,9 and 12 months. It is hypothesized that the Nimbus electrode will result in a greater reduction and improvement in PROMIS scores for a longer duration than the Stryker electrode.

Read the detailed description

This study is a single center double-blinded prospective randomized clinical trial. Patients will be recruited from the pool of patients seen by the Principal Investigators (PIs) and collaborating physicians in the UAMS pain management clinic through the Department of Anesthesiology. Candidacy for RFA is determined by the standard of care which includes diagnosis of axial low back pain without lower extremity radiation or other primary pain generators. These patients should not have had previous RFA's in the lumbar region before. These patients should receive greater than 80% pain relief following two diagnostic MBBs completed at separate times. In routine care, physicians discuss with patients the risks and benefits associated with the RFA procedure. In order to establish a baseline level of pain, disability, and impairment of daily living, patients are routinely asked to complete the PROMIS-29 questionnaire to the best of their ability. Once patients receive their second MBB they are to return 2 to 4 weeks later for RFA should they meet the necessary 80% pain relief. At the time of the procedure, a simple randomization performed by a staff member not involved in the patient's care, will be used to determine if the patient's procedure will involve the use of the Stratus Nimbus or the Stryker Venom electrode and cannula set. The provider performing the procedure will be made aware of which electrode is to be used. However, patients will be blinded to the group to which they were randomized. Patients will continue with conventional RFA as per standard of care. Patients will then be contacted at 1,3,6, 9, and 12 months for assessment of response to intervention including the PROMIS-29 questionnaire. Scores are then compared to those taken at baseline to determine efficacy of treatment and inform future care.

02

Conditions studied

  • Lumbar Spondylosis

Keywords

  • Radiofrequency Ablation
  • Lower Back Pain
  • Lumbar Spondylosis
03

In context

Spondylosis

142 studies on the registry are indexed under Spondylosis; 42 are open to participants now.

This study's planned enrollment of 25 is below the median of 60 across 101 interventional studies indexed under Spondylosis.

Browse Spondylosis studies →

Lead sponsor

University of Arkansas is the lead sponsor of 399 studies on the registry; 38 are open to participants now.

Of its 37 completed or terminated interventional studies of FDA-regulated products, 34 (92%) have results posted.

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

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Greater than 18 years of age
  2. Presenting with chronic non-radicular lower back pain
  3. Failure of conservative treatment such as physical therapy or NSAID usage
  4. Diagnosis of lumbar facet mediated lower back pain by a board-certified chronic pain physician via two sets of prognostic lumbar MBBs with 0.5cc of 0.5% bupivacaine with >80% pain relief

Exclusion criteria

Exclusion Criteria:

  1. History of known coagulopathy
  2. > 3 Classification
  3. Pregnancy
  4. Spinal hardware between L3 and S1
  5. Allergies to injection medications
  6. English illiteracy
  7. Pain improvement following physical therapy or NSAID usage
  8. Previous history of attempted lumbar RFA
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

05

Study design

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

Study arms

  • Active comparator
    Stratus Nimbus

    Patients will receive their radiofrequency ablation procedure of the lumbar medial branch nerves with the Stratus Nimbus Electrode.

    Device: Stratus Nimbus Electrosurgical RF Multi-Tined Expandable Electrode

  • Active comparator
    Stryker Venom

    Patients will receive their radiofrequency ablation procedure of the lumbar medial branch nerves with the Stryker Venom Cannula.

    Device: Stryker Venom Radiofrequency Cannula

Interventions

  • DeviceStratus Nimbus Electrosurgical RF Multi-Tined Expandable Electrode

    Radiofrequency Ablation of Lumbar Medial Branch Nerves using the Stratus Nimbus Electrode

  • DeviceStryker Venom Radiofrequency Cannula

    Radiofrequency Ablation of Lumbar Medial Branch Nerves using the Stryker Venom Cannula

06

What researchers measure

Primary outcomes

  1. PROMIS Outcomes

    The PROMIS (Patient Reported Outcomes Measurement Information System) outcomes as reported by the PROMIS-29 questionnaire serve as an indicator for pain severity and impairment of activities of daily living. The PROMIS-29 questionnaire which assess 7 heath domains which include 4 survey items with scores ranging from 0 being no impairment and 5 being the most severe impairment. The questionnaire also assess the patient's pain on a numerical scale from 0 being no pain and 10 being the worst pain experienced by the patient. Both components are then used to assess impairment of daily activities using composite T-scores which are calculated from the raw data. T-Scores between 40-45 is considered mild impairment, 30-40 is considered moderate impairment, and less then 30 is considered severe impairment.

    Time frame: 0, 1, 3, 6, 9, and 12 months from procedure date

07

Study locations

1 of 1 sites recruiting
  • University of Arkansas for Medical Sciences
    Little Rock, Arkansas 72205, United States
    Recruiting
    • Aparna Jindal, MD · Contactajindal@uams.edu · 3195125259
    • Edward Denton, BS · Sub investigator
    • Johnathan Goree, MD · Sub investigator
    • Gregory L Smith, MD · Sub investigator
    • Aparna Jindal, MD · Principal investigator
    • Christopher Maranto, MD · Sub investigator
    • Ahad Nadeem, BS · Sub investigator
    • Attwal Sawan, BS · Sub investigator
08

References and documents

Publications

  • Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain. 1993 Sep;9(3):174-82. doi: 10.1097/00002508-199309000-00004. PubMed 8219517 ↗
  • Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity? Spine (Phila Pa 1976). 1994 May 15;19(10):1132-7. doi: 10.1097/00007632-199405001-00006. PubMed 8059268 ↗
  • Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007 Mar;106(3):591-614. doi: 10.1097/00000542-200703000-00024. PubMed 17325518 ↗
  • Lainez Ramos-Bossini AJ, Jimenez Gutierrez PM, Ruiz Santiago F. Efficacy of radiofrequency in lumbar facet joint pain: a systematic review and meta-analysis of placebo-controlled randomized controlled trials. Radiol Med. 2024 May;129(5):794-806. doi: 10.1007/s11547-024-01809-8. Epub 2024 Mar 21. PubMed 38512629 ↗
  • Li SJ, Zhang SL, Feng D. A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain. J Orthop Surg Res. 2023 May 5;18(1):331. doi: 10.1186/s13018-023-03814-5. PubMed 37143095 ↗
  • Cedeno DL, Vallejo A, Kelley CA, Tilley DM, Kumar N. Comparisons of Lesion Volumes and Shapes Produced by a Radiofrequency System with a Cooled, a Protruding, or a Monopolar Probe. Pain Physician. 2017 Sep;20(6):E915-E922. PubMed 28934795 ↗
  • Manchikanti L, Kaye AD, Soin A, Albers SL, Beall D, Latchaw R, Sanapati MR, Shah S, Atluri S, Abd-Elsayed A, Abdi S, Aydin S, Bakshi S, Boswell MV, Buenaventura R, Cabaret J, Calodney AK, Candido KD, Christo PJ, Cintron L, Diwan S, Gharibo C, Grider J, Gupta M, Haney B, Harned ME, Helm Ii S, Jameson J, Jha S, Kaye AM, Knezevic NN, Kosanovic R, Manchikanti MV, Navani A, Racz G, Pampati V, Pasupuleti R, Philip C, Rajput K, Sehgal N, Sudarshan G, Vanaparthy R, Wargo BW, Hirsch JA. Comprehensive Evidence-Based Guidelines for Facet Joint Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Facet Joint Interventions 2020 Guidelines. Pain Physician. 2020 May;23(3S):S1-S127. PubMed 32503359 ↗
  • Kornick C, Kramarich SS, Lamer TJ, Todd Sitzman B. Complications of lumbar facet radiofrequency denervation. Spine (Phila Pa 1976). 2004 Jun 15;29(12):1352-4. doi: 10.1097/01.brs.0000128263.67291.a0. PubMed 15187637 ↗
  • Bogduk N, Dreyfuss P, Baker R, Yin W, Landers M, Hammer M, Aprill C. Complications of spinal diagnostic and treatment procedures. Pain Med. 2008;9
  • Carr CM, Plastaras CT, Pingree MJ, Smuck M, Maus TP, Geske JR, El-Yahchouchi CA, McCormick ZL, Kennedy DJ. Immediate Adverse Events in Interventional Pain Procedures: A Multi-Institutional Study. Pain Med. 2016 Dec;17(12):2155-2161. doi: 10.1093/pm/pnw051. Epub 2016 Apr 15. PubMed 28025351 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06477094
Responsible party
Sponsor
First posted
Jun 27, 2024
Start date
Aug 9, 2024
Primary completion
Jul 31, 2027 (estimated)
Completion
Sep 30, 2027 (estimated)
Last update
Sep 10, 2026

Study contacts

Edward Denton, MD
Contact
edenton@uams.edu
9018323377
Edward E Denton, BS
Contact
edenton@uams.edu
9018323377
Aparna Jindal, MD
principal investigator · University of Arkansas

Oversight

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

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