Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID06996574

A Pragmatic Randomised Multi-centre Trial Comparing an All-in-one Procedure to At-home Screening Trial in Chronic Pain Patients Using Closed-loop Spinal Cord Stimulation

Led by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) · Updated on 2025-07-10

180

Participants Needed

1

Research Sites

N/A

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating the effectiveness and cost utility of an all-in-one spinal cord stimulation (SCS) procedure compared to the standard two-step approach that includes an at-home screening trial. This pragmatic, multi-center, randomized non-inferiority trial focuses on adult patients in the Netherlands with chronic neuropathic pain conditions such as persistent spinal pain syndrome, painful diabetic neuropathy, complex regional pain syndrome, and small fibre neuropathy. The study aims to assess whether the all-in-one procedure is as effective as the traditional screening trial method, which can be costly and carry risks like infection. Participants are randomly assigned to either the all-in-one procedure group (no trial group, NTG) or the standard two-phase closed-loop SCS procedure with an at-home screening trial group (trial group, TG). Both approaches involve closed-loop SCS, with the trial group undergoing a temporary screening trial to confirm at least 50% pain reduction before permanent implantation. The all-in-one group receives the full implantation procedure without prior screening. Treatments are delivered under everyday clinical practice settings to inform clinical decisions and health policy. During the study, participants will be monitored for changes in pain intensity using the Numeric Rating Scale (NRS) up to six months after lead implantation. They are also asked to complete additional trial-related questionnaires. Researchers will evaluate pain reduction and cost utility between the two approaches. The study includes single masking and randomization with follow-up visits and assessments to track outcomes and safety throughout the trial period, which begins in June 2025 and is expected to conclude by April 2028.

CONDITIONS

Brief Title

Study to Compare the Clinical Effectiveness and Cost Utility of an All-in-one Procedure With an At-home Screening Trial

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Diagnosed with chronic neuropathic pain such as persistent spinal pain syndrome, painful diabetic neuropathy, complex regional pain syndrome, or small fibre neuropathy
  • Adult patients aged 18 years or older
  • Chronic pain for at least 6 months
  • Pain intensity of 50mm or higher on VAS or 5 or higher on NRS
  • Suitable candidates for closed-loop spinal cord stimulation
  • Willing to complete additional trial-related questionnaires
  • Able to give informed consent
Not Eligible

You will not qualify if you...

  • History of drug abuse, pregnancy, coagulation disorders, or use of anticoagulation therapy that cannot be temporarily stopped
  • Active infection
  • Life expectancy of less than 12 months
  • Incomplete intake questionnaires "PROMS neuromodulatie"
  • Existing drug pump, spinal cord stimulation system, or other active implantable devices like pacemakers, deep brain stimulators, or sacral nerve stimulators
  • Current or previous treatment with an implanted pain reduction device
  • Participation in another clinical trial that may affect the results of this trial

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Up to 6 months post lead implant

Participants receive either an all-in-one procedure or the established two-phase closed-loop spinal cord stimulation procedure with an at-home screening trial as part of their chronic pain management.

Visits scheduled according to the treatment protocol during 6 months

Trial Site Locations

Total: 1 location

1

Amsterdam UMC

Amsterdam, Netherlands

Actively Recruiting

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Research Team

E

E de Klerk S drs., Master of Science

C

Carin Wensing drs, Master of Science

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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