Nerve Root Block Versus Surgery (NERVES)
Research type
Research Study
Full title
Multi-centre randomised control trial comparing the clinical and cost effectiveness of trans-foraminal epidural steroid injection to surgical microdiscectomy for the treatment of chronic radicular pain secondary to prolapsed intervertebral disc herniation: NErve Root Block VErsus Surgery (NERVES)
IRAS ID
160371
Contact name
Dave Watling
Contact email
Sponsor organisation
The Walton Centre NHS Foundation Trust
Eudract number
2014-002751-25
ISRCTN Number
ISRCTN04820368
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
The NERVES study aims is to find out if local anaesthetic and steroid injection (TFESI) administered accurately to the source of radicular leg pain can provide a faster, cheaper and more effective treatment for patients with persistent sciatica than an invasive surgical procedure (microdiscectomy). The study’s findings should help advise clinicians on which treatment type may bring the most benefit to patients.
Two hundred patients aged between 16 and 65 years with recently diagnosed sciatica secondary to a prolapsed (slipped) disc will be recruited from centres in the UK. Patient will have had symptoms for between 6 weeks and 6 months.
The trial will be run in NHS neurosurgical, pain and orthopaedic clinics. Patients who would like to take part will be allocated to either the epidural steroid injection or microdiscectomy by a process called ‘randomisation’ with an aim for a 50/50 split of each treatment. The treatment will take place between 4-6 weeks after randomisation. Prior to treatment and then again at 3 months after treatment the patient will be asked to complete questionnaires to assess how successful the treatment has been. These questionnaires will be repeated at 6, 9 and 12 months after treatment to measure the ongoing results of the treatment options.
Both of the treatment options offered as part of this trial are currently used by the NHS as treatments for sciatica secondary to a prolapsed disc and are considered effective therapies. The main benefit for patients will be the reduction of pain as both treatments are recognised therapies for sciatica. The main risk is that a patient may be randomised to a treatment that is found to be less effective at the end of the trial.
The side effects are those commonly associated with spinal surgery or injection; these are well documented.REC name
North West - Liverpool Central Research Ethics Committee
REC reference
14/NW/1219
Date of REC Opinion
8 Oct 2014
REC opinion
Further Information Favourable Opinion