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Tracking Information | |||||
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First Received Date † | June 27, 2007 | ||||
Last Updated Date | May 30, 2008 | ||||
Start Date † | July 2007 | ||||
Current Primary Outcome Measures † |
Spinal fusion and the rate of fusion and maintenance of spinal alignment will be assessed [ Time Frame: 6 weeks, 3, 6, 12, and 24months. ] [ Designated as safety issue: Yes ] | ||||
Original Primary Outcome Measures † | Same as current | ||||
Change History | Complete list of historical versions of study NCT00493558 on ClinicalTrials.gov Archive Site | ||||
Current Secondary Outcome Measures † |
Subjective outcome questionnaires will be used to characterize the patient sample used for the study to allow for comparisons to other treatments for this condition in the future. [ Time Frame: 3, 6, 12, 24 months ] [ Designated as safety issue: Yes ] | ||||
Original Secondary Outcome Measures † | Same as current | ||||
Descriptive Information | |||||
Brief Title † | Spine Research With Roentgen Stereophotogrammetric Analysis | ||||
Official Title † | A Consecutive Case Series of One-Level Lumbar Fusions With Pedicle Screw Instrumentation and the Trabecular Metal™ Intervertebral Cage Using Roentgen Stereophotogrammetric Analysis (RSA) | ||||
Brief Summary | The purpose of this study is to gather information on the effectiveness of a new spine implant for patients who require spinal fusion surgery. Based on this information, we hope to create a standard of good performance, or benchmark, against which future studies on this spine implant can be compared. By creating this benchmark we hope to improve care for patients who require spinal fusion surgery. |
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Detailed Description | For patients in whom a spinal fusion is indicated, the posterior lumbar interbody fusion (PLIF) may be recommended to restore stability to the affected spinal segment1. Pioneered by Cloward in the 1940s to treat painful intervertebral discs damaged by degeneration, PLIF involves removal of the entire nuclear portion of the disc and subsequent replacement with multiple blocks of transplanted bone2.The purpose of the fusion is to eliminate or reduce the amount of the motion at the affected site, and, therefore, the source of pain. Four major intervertebral cages have been approved by the Food and Drug Administration (FDA) for use in humans: the Brantigan I/F Cage, the Ray TFC Threaded Fusion Cage, the Bagby and Kuslich (BAK) cage, and, most recently, the Trabecular Metal™ Cage. Comprised of 98 percent tantalum and 2 percent vitreous carbon, Trabecular Metal™ has the highest coefficient of friction of any implant material on the market, allowing for optimal initial implant-bone fit. Furthermore, the unique porous structure of Trabecular Metal™ provides significantly more space for tissue ingrowth to occur, facilitating a more cohesive implant-bone interface as well as long-term stability of the implant. Long-term follow up data on the efficacy of the Brantigan I/F, Ray TFC, and BAK cages are limited, with the most rigorous studies (i.e. controlled prospective studies) typically providing outcomes approximately 2 years post-surgery. Overall, these studies show that, while existing intervertebral cages have made significant advances in terms of addressing the disadvantages associated with traditional bone grafting/fixation techniques, problems continue to persist. Through comprehensive and accurate clinical evaluation of the Trabecular Metal™ intervertebral cage, the Research Team hopes to document advances in the PLIF technique, thereby informing current research as well as clinical practice. The primary goal of the proposed research is to gather data on the clinical efficacy of the Trabecular Metal™ Posterior Lumbar Interbody Fusion (PLIF) cage with pedicle screw instrumentation for the treatment of one-level lumbar spine fusions. Based on this pilot data, we hope to establish a level of acceptable clinical performance for the Trabecular Metal™ cage, a benchmark against which subsequent investigations can be compared. Direct surgical exploration is considered the most reliable method for accurately determining fusion success, both from a structural and functional perspective, following spinal fusion surgery. Unfortunately, this method is highly invasive, costly and seldom used.Furthermore, surgical exploration does not provide any longitudinal information as to the stability of the implant, including the monitoring of any occurrence of migration. In contrast, Roentgen Stereophotogrammetric Analysis (RSA)can detect the presence or absence of mobility between intervertebral segments (i.e. functional stability of the fusion) with a high degree of accuracy. RSA is a radiographic technique that uses small tantalum balls implanted into the patient's bone to measure micromotion (<1 mm) at the bone - implant interface, something which is not possible to do reliably using regular x-ray techniques. RSA provides a method for detecting inferior implant designs or cement formulations using only a small number of patients before release of these products into large clinical trials. RSA has been in use for several decades,and its safety is well documented.A computerized, digital RSA system has recently been installed and calibrated at our center. Its measurement capabilities have been rigorously validated, and it is currently being used to assess a new knee implant design. Expansion of the system to include spine RSA can be easily accomplished. |
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Study Phase | Phase IV | ||||
Study Type † | Interventional | ||||
Study Design † | Treatment, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study | ||||
Condition † |
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Intervention † | Device: Trabecular Metal Intervertebral Cage with Roentgen Stereophotogrammetric Analysis beads | ||||
Study Arms / Comparison Groups | |||||
Publications * | |||||
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline. |
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Recruitment Information | |||||
Recruitment Status † | Recruiting | ||||
Enrollment † | 25 | ||||
Completion Date | |||||
Estimated Primary Completion Date | December 2011 (final data collection date for primary outcome measure) | ||||
Eligibility Criteria † | Inclusion Criteria:
Exclusion Criteria:
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Gender | Both | ||||
Ages | 20 Years and older | ||||
Accepts Healthy Volunteers | No | ||||
Contacts †† |
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Location Countries † | Canada | ||||
Expanded Access Status | |||||
Administrative Information | |||||
NCT ID † | NCT00493558 | ||||
Responsible Party | Dr. William Oxner M.D., Principal Investigator | ||||
Secondary IDs †† | |||||
Study Sponsor † | Capital District Health Authority, Canada | ||||
Collaborators †† | Zimmer, Inc. | ||||
Investigators † |
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Information Provided By | Capital District Health Authority, Canada | ||||
Verification Date | May 2008 | ||||
† Required WHO trial registration data element. †† WHO trial registration data element that is required only if it exists. |