Injectable hydrogel could ease back pain without surgery
NCT ID NCT06011551
First seen Jun 27, 2026 · Last updated Sep 18, 2026 · Updated 5 times
Summary
This study tests a hydrogel implant injected into damaged spinal discs to treat degenerative disc disease. About 225 adults with chronic low back pain will receive either the implant or standard care like physical therapy. The goal is to see if the implant safely improves pain and function over 12 months.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- hydrogel implant (injected into the disc)
- What this could lead to
- If it works, this could offer a less invasive way to treat chronic back pain from disc degeneration, potentially delaying or avoiding surgery.
- What could go wrong
- This is a pivotal study, but the implant is new and long-term results are unknown. There is a risk of infection, implant failure, or no improvement over standard care.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
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About 225 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Jan 2025
- Expected to finish
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Dec 2028
An estimate. End dates often move.
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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22 to 85 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Male or female subjects aged 22 to 85 years, inclusive * Subjects presenting with LBP greater than leg pain and symptoms of DDD of the lumbar region (L1- S1) of at least six (6) months duration * Presence of one (1) or two (2) symptomatic disc(s) (i.e., only 1-level or 2-levels may be treated during the study) as determined by Discography * Symptomatic disc(s) exhibiting Grade 4 to 8 degeneration on the modified Pfirrmann scale as determined by MRI * Failure to have their symptoms resolve or reduce following at least six (6) months of conservative care (as defined in the body of the protocol) * Psychosocially, mentally and physically able and willing to fully comply with this protocol including adhering to follow-up schedule and requirements and filling out forms * English fluency * Signed informed consent Exclusion Criteria: * Active systemic or local infection * Any skin disease or inadequate tissue coverage at the site of the proposed injection * Annular tear or defect that shows free contrast extravasation into the epidural space during or after Discography * Presence of more than two (2) symptomatic discs presenting with pain confirmed during Discography * Presence of extruded or sequestered disc herniation (i.e., disc extrusions or sequestrations) at the symptomatic level(s) or on adjacent levels * Presence of wide annular fissures confluent with large disc protrusions at the symptomatic level(s) * Epidural steroid injection, intradiscal injection, trigger point injection, facet or medial branch block within 60 days of randomization * Opioid medication usage \>60 MME (morphine milligram equivalent)/day or increase in opioid use within 60 days of randomization * Evidence of Modic type 3 changes at the symptomatic level(s) or on adjacent levels * Subjects presenting with nerve pain following a dermatomal distribution and that correlates with nerve compression on imaging where lower limb pain is greater than back pain or by history within the past six (6) months. Note: somatic referred pain is allowed * Evidence of neurogenic claudication due to spinal stenosis * Subjects having had any prior lumbar spine surgery (instrumented or non-instrumented) except: a. A non-instrumented procedure not at the symptomatic or adjacent levels (i.e., discectomy, laminectomy, MILD procedure) is not exclusionary if the procedure was completed at least one (1) year or greater from randomization with complete resolution of treated symptoms and no recurrence * History of vertebral fractures in the lumbar spine * Evidence of severe compression of cauda equina * Evidence of spinal segmental instability (spondylolysis or spondylolisthesis: Grade \>1), severe spinal canal stenosis, isthmus pathology, or scoliosis \[Cobb angle \>20 at the index level(s)\] * Subjects with arachnoiditis * Subjects who are prisoners or wards of courts * Subjects involved in active litigation including worker's compensation cases * Subjects on chronic anticoagulation due to a bleeding disorder and unable to safely stop anticoagulants, or has taken anticoagulants within three (3) days prior to procedure * Subjects with LBP of non-spinal or unknown etiology * Subjects who have a history (in the last five (5) years) of substance abuse or chemical dependency (pharmaceuticals, illicit drugs, alcohol) or are current abusers (using definition criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)) * Subjects who have major psychiatric disorders, such as major depression, bipolar disorder and schizophrenia, as defined by the DSM-V * If female, subjects who are pregnant or are trying to become pregnant during the course of the trial (due to risks of additional radiation exposures) * Failure to understand informed consent or inability or unwillingness to adhere to the study follow-up visit schedule or other protocol requirements * Subjects who have participated in any other clinical study within the last three (3) months that, in the opinion of the investigator, could bias the results of the HYDRAFIL-D study, or subjects that are actively participating in any other clinical study, or have planned participation in any other clinical study during the course of this trial. Note: subjects must agree they will not participate in any other clinical study during the course of this trial * Body Mass Index (BMI) \>40 kg/m2 * Known allergy or hypersensitivity to any of the device materials * Endocrine or metabolic disorder known to affect osteogenesis * Insulin-dependent diabetes mellitus * Inability to undergo X-ray, MRI, CT scans or other radiographic assessments, including Discography * Any comorbid medical condition which, in the best judgement of the Investigator, would make the subject unsuitable for inclusion in the study or interferes with the proper assessment of safety or effectiveness (e.g., systemic disease) * Subjects with any active malignancy or who have been previously diagnosed with a malignancy and have evidence of residual disease * Any degenerative or neurological condition that would interfere with evaluation of outcomes or that may generate an unacceptable risk of failure or postoperative complications * Chronic or acute renal and/ or hepatic impairment * Evidence of severe osteoporosis. The SCORE/MORES will be utilized to screen if a DEXA scan is indicated. If SCORE/MORES value ≥ 6; then a DEXA scan is required. Severe osteoporosis is defined as DEXA T-score \< -2.5 (spine or hip) or QCT T-score \< 80mg/cubic cm
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
15 sites in 2 countries. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Alabama Clinical Therapeutics
RECRUITINGBirmingham, Alabama, 35235, United States
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Beam Research (Beam Radiology)
RECRUITINGCalgary, Alberta, T3R 0N2, Canada
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Boomerang Healthcare (IPM Medical Group)
RECRUITINGWalnut Creek, California, 94598, United States
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Clinical Investigations
RECRUITINGEdmond, Oklahoma, 73103, United States
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DBPS Research (The Denver Spine & Pain Institute)
RECRUITINGGreenwood Village, Colorado, 80111, United States
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Horizon Clinical Research (Southern Pain and Spine)
RECRUITINGJasper, Georgia, 30143, United States
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International Spine, Pain & Performance Center and Mountain Spine & Pain
ACTIVE_NOT_RECRUITINGWashington D.C., District of Columbia, 20006, United States
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NRSA Group (Florida Spine & Pain Specialists)
RECRUITINGRiverview, Florida, 33569, United States
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Neuroscience Research Center, LLC
RECRUITINGOverland Park, Kansas, 66210, United States
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Precision Spine Care
RECRUITINGTyler, Texas, 75701, United States
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Source Healthcare
RECRUITINGSanta Monica, California, 90403, United States
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Southwest Florida Pain Center
RECRUITINGPort Charlotte, Florida, 33948, United States
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Spine Institute of Louisiana (The Spine Network)
RECRUITINGShreveport, Louisiana, 71101, United States
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Tenet Florida Physician Services II (Cantor Spine Center at The Paley Orthopedic and Spine Institute)
RECRUITINGWest Palm Beach, Florida, 33407, United States
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The Orthopaedic Institute
RECRUITINGGainesville, Florida, 32607, United States
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Virginia iSpine Physicians
RECRUITINGRichmond, Virginia, 23238, United States
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