Clinical Research Directory

PRP Versus NP Injections for Chronic Discogenic Low Back Pain

The purpose of this randomized, single-blind comparative-effectiveness pilot study is to compare the effectiveness of two types of injections on pain and function over 6 months in patients with chronic discogenic (originating from the intervertebral discs) low back pain (LBP). Eligible participants will have failed an adequate trial of previous conservative treatments, had no prior surgery, and had no prior injections within the preceding 12 months of study participation. One of the treatments in this study is called platelet-rich plasma (PRP). It uses a sample of a participant's own blood, which is spun in a machine to concentrate the platelets. These platelets are then injected into the participant's back to help healing and reduce pain and swelling. The other treatment available in this study uses donor tissue from the center of a spinal disc, called the nucleus pulposus (NP). This gel-like material normally helps absorb shock in the spine. In this therapy, NP tissue from a donor is injected into the damaged disc to help restore its cushioning function and replace lost tissue. In this study, participants will be randomly assigned to receive one of the two injections (either PRP or NP) to treat chronic discogenic LBP. In order to limit bias in outcome data, participants will not know what injection they received until 6 months post-procedure. Participants will be asked to complete between 5-6 in-person visits with the study team. Beyond procedure-related activities including a blood draw and injection, participants will also complete questionnaires and physical examinations at the respective study visits.

McKenzie Extension Protocol Versus Core Stability Exercises Combined With Spinal Decompression in Discogenic Lumbar Radiculopathy

The pathophysiology arises from structural and biochemical degeneration within the intervertebral disc rather than direct nerve root compression alone. When radicular symptoms are present, patients frequently experience a combination of localized lumbar pain, radiating leg pain, reduced spinal mobility, and impaired daily function. Non-surgical spinal decompression therapy is frequently employed as a conservative treatment for lumbar disc pathology due to its capacity to reduce intradiscal pressure, increase disc height, and unload compressed neural structures. Nevertheless, decompression alone does not fully restore neuromuscular control or spinal stability; it is consequently commonly paired with an active exercise approach. Two of the most widely utilized adjunct approaches are the McKenzie Extension Protocol, which employs directional-preference movements and repeated end-range loading to promote symptom centralization, and Core Stability Exercises, which target the deep trunk stabilizers to improve segmental control of the lumbar spine. Although each approach is independently supported by evidence, no recent trial has directly compared their effectiveness when each is combined with spinal decompression therapy in patients with MRI-confirmed discogenic low back pain accompanied by radiculopathy. This evidence gap consequently leaves clinicians without clear guidance on which combined strategy to select. The present study is a single-blind randomized controlled trial designed to determine and compare the effects of the McKenzie Extension Protocol versus Core Stability Exercises, each combined with spinal decompression therapy, on pain intensity, functional disability, and lumbar range of motion in adults with MRI-confirmed discogenic low back pain and radiculopathy. Forty-two participants aged 25-45 years, with a posterolateral disc bulge confirmed on MRI, a Numeric Pain Rating Scale (NPRS) score greater than 3, and a positive Straight Leg Raise test, will be recruited using purposive sampling and randomly allocated by lottery method into two equal groups of 21. Group A will receive spinal decompression therapy followed by McKenzie extension-based exercises, while Group B will receive the same decompression protocol followed by core stabilization exercises such as abdominal drawing-in, bridging, bird-dog, and side-plank variations. Both groups will also receive standardized adjunct modalities, including moist heat and interferential current therapy, and will attend three sessions per week for four consecutive weeks, totaling 12 sessions. Outcomes will be assessed at baseline and immediately after the four-week intervention period by a blinded assessor to minimize bias. The primary outcome measures include pain intensity (NPRS), functional disability (Oswestry Disability Index), lumbar range of motion (inclinometer), and lower-limb neural mobility (Straight Leg Raise angle). Data will be analyzed using SPSS to compare within-group and between-group changes across the two interventions. This trial is anticipated to generate direct comparative evidence on which combined rehabilitation strategy, either decompression with McKenzie exercises or decompression with core stability exercises, produces superior clinical outcomes for this patient population. Given that current clinical guidelines do not specify a preferred adjunct approach for discogenic radiculopathy managed with decompression, the findings are intended to assist physiotherapists in selecting more targeted, evidence-based rehabilitation protocols. Such evidence may potentially improve pain relief, functional recovery, and cost-effectiveness of care, while simultaneously reducing the long-term burden associated with chronic low back pain.

PerQdisc Traditional Feasibility Trial.

This is a traditional feasibility study (TFS) study to evaluate the safety and effectiveness of the PerQdisc. The study is prospective, multicenter, and open label. After a screening period, qualified participants will be enrolled and treated with the PerQdisc. Patients will not be blinded to their treatment. Participants will then complete the safety follow-up period.

Electroacupuncture Treatment for Discogenic Low Back Pain

Low back pain (LBP) is a prevalent clinical condition characterized by pain localized between the lower edge of the 12th rib and the gluteal fold.The incidence of LBP has been escalating annually.An epidemiological survey encompassing 204 countries and territories globally projects a stark increase in the affected population, from an estimated 619 million in 2020 to a projected 843 million by 2050.LBP can affect individuals across all age groups, with a lifetime prevalence ranging from 60% to 80%, significantly impairing quality of life. Discogenic low back pain (DLBP), attributed to degenerative changes in the intervertebral discs, is the predominant subtype of LBP, comprising approximately 39% of all LBP cases. Disc degeneration typically initiates in early adulthood and progresses with age, potentially leading to DLBP.As the population ages, DLBP has emerged as a major contributor to disability worldwide, imposing a substantial burden on both individuals and society. Current international guidelines establish the foundation for surgical and pharmacological interventions for DLBP.However, considering the adverse effects and economic implications associated with surgical and medical treatments, there is a growing inclination towards recommending non-pharmacological therapies.These include physiotherapy, self-management, and psychotherapy, with a concurrent reduction in emphasis on pharmacological and surgical options. Acupuncture and moxibustion are integral components of traditional Chinese medicine, garnering global recognition for their role in restoring the equilibrium of yin and yang within the human body . Electroacupuncture, a modern derivation of traditional acupuncture, has been extensively applied worldwide for the management of various painful conditions, including headache, myofibromyalgia, neck pain, and cancer-related pain. Despite its broad application, a limited number of clinical efficacy and safety studies have been conducted on electroacupuncture for the treatment of discogenic low back pain (DLBP), thereby necessitating a scientific foundation for its therapeutic use . The present study aims to investigate the clinical efficacy and safety of electroacupuncture in the treatment of DLBP using an evidence-based medical approach. By employing a multicenter, randomized, and sham-controlled study design, this investigation seeks to provide a robust evidence-based medical foundation for the use of electroacupuncture in DLBP treatment. Participants will be randomly assigned to either the acupuncture group (experimental group) or the sham acupuncture group (control group) in a 1:1 ratio, akin to a lottery drawing. Following enrollment, participants will undergo a 4-week, 12-session intervention, followed by three follow-up visits at 4, 12, and 24 weeks post-treatment. The investigators will assess participants' low back pain, lumbar spine function, and quality of life through telephone communication or on-site questioning at these designated follow-up intervals. Needling may result in minor bleeding, pain, or hematoma at the needle site, and rare infections or allergic reactions may occur. Adverse reactions to needling, such as dizziness or nerve damage, are exceedingly rare. Participants in this study may confer direct medical benefits, such as remission of symptoms, or may not, with outcomes ranging from no remission to potential exacerbation of the condition . However, the knowledge gained from this study is anticipated to benefit future people with similar conditions . In addition to this study , participations may opt for treatment with modern rehabilitation medicine modalities or medications, including shortwave therapy, intermediate frequency therapy, or oral analgesics . This study would not impose any costs beyond the participants' regular medical treatment, and the investigators will cover all study-related medical expenses (including acupuncture treatment costs, needle costs, and scale evaluation costs) . The investigators are legally committed to maintaining the confidentiality of the participants' study records.

RenewDisc Trial: Endoscopic Discectomy and Autologous Stem Cell Therapy for Discogenic Low Back Pain

he RenewDisc Trial is a prospective observational clinical study evaluating outcomes in patients with confirmed discogenic low back pain who undergo standard clinical care using endoscopic spine procedures. The study observes and compares clinical, functional, and imaging outcomes following endoscopic discectomy, endoscopic discectomy combined with autologous mesenchymal stem cell therapy, or standalone endoscopic application of autologous mesenchymal stem cells. Participants are treated according to routine clinical decision-making, and no interventions are assigned by the study protocol. Data are collected prospectively at predefined follow-up intervals to assess pain intensity, functional disability, quality of life, and structural changes on magnetic resonance imaging.