sciatica and herniated nucleus pulposus
Conditions
Interventions
The combination intervention (MDT and TESIs) will be administered as follows
Using MDT principles and based on pain responses, participants are classified
as centralizers or non-centralizers. Centralizers get specific MDT exercises
and advice. Non-centralizers will be inject
1)
resolved symptoms
2) centralizing and significantly less pain, 3) non
centralizing and significantly less pain and 4) non-centralizing with high
levels of pain. In the first three groups mentioned here, patients will
non-centralising with high levels of pain will be referred back for
surgery.
Patients randomized to the control intervention group will placed on a waiting
list and scheduled to receive lumbar disc
Injection
Sciatica
Surgery
Sponsors
ZonMw
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: • Incapacitating lumbosacral radicular syndrome with leg pain, NRS>6, (with or without back pain) that had lasted for a minimum of 6 weeks with or without mild neurological deficit, medical research council (MRC) muscle scale higher than 3 • Magnetic resonance imaging (MRI) which confirms a lumbar HNP that compromises the spinal nerve and can explain the clinical symptoms of the patient • The patients should according to usual care have an indication for lumbar HNP operation by a neurosurgeon. • Signed informed consent for participation in the study • 18 years and above
Exclusion criteria
Exclusion criteria: • Patients suffering from cauda equina syndrome • Previous spine surgery at the same level during the previous 6 months • Previous transforminal injections at the same level during the previous 6 months • Bony stenosis • Spondylolisthesis • Pregnancy • Complicated disc herniation requiring more operations • Severe coexisting disease e.g. osteoporosis, dementia • Patient with contra-indications for steroids injections • Insufficient knowledge of the Dutch language • Emergency surgery as determined by the neurosurgeon • Being allergic for OMNIPAQUE 240
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Surgery rate (number of patients undergoing surgery during a 12-month follow-up) | — |
Secondary
| Measure | Time frame |
|---|---|
| Back and leg pain intensity (NPRS), physical functioning (RMDQ-23), self-perceived recovery (GPE), health-related quality of life (EQ-5D-5L) en societal costs. | — |
Countries
The Netherlands
Outcome results
None listed