The Norwegian Cervical Arthroplasty Trial (NORCAT)
Treatment of Cervical Radiculopathy With Arthroplasty Compared With Discectomy With Fusion and Cage (ACDF. Clinical, Radiological and Biomechanical Aspects. A Randomized Multicenter Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Trondheim, Norway, 7004
- St. Olavs Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 25 - 60 years
- Clinical C6 or C7 root radiculopathy with corresponding radiologic findings with or without neurological symptoms
- Mechanical provoked pain which aggravate with physical activity or positive Spurling test
- Radiological nerve root compression on the basis of disc herniation or spondylosis
- NDI =/> 30 percent
- The patient has not responded to non-operative treatment and shown no sign of improvement during the last 6 weeks
Exclusion Criteria:
- Significant spondylosis involving more than one level
- Intramedullary changes on MRI
- Ankylosis at adjacent level
- Clinical suspicion of myelopathy
- Chronic generalised pain syndrome
- Infection
- Active cancer
- Rheumatoid arthritis involving the cervical spine
- Previous trauma involving the cervical spine
- Pregnancy
- Allergy against contents in cage/artificial disc
- Previous neck surgery
- Psychological or somatic illness that causes the patient not to be suitable for the study
- The patient does not understand Norwegian orally or in writing.
- Abuse of medication/narcotics
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Artificial Cervical Disc
Anterior cervical discectomy, followed by insertion of the Discover™ Artificial Cervical Disc
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Anterior cervical discectomy, followed by insertion of the Discover™ Artificial Cervical Disc
Other Names:
|
|
Active Comparator: ACDF
Anterior cervical discectomy and fusion (ACDF)
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Anterior cervical discectomy and decompression, followed by insertion of a PEEK cage, which induces fusion.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
change in Neck Disability Index (NDI)
Time Frame: up to 5 years
|
up to 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Clinical effect, measured by use of EQ5-D, SF-36, numeric arm/neck pain registration, dysphagia score, rate of complications/reoperations/morbidity
Time Frame: Preoperatively. Postoperatively: 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years
|
Preoperatively. Postoperatively: 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years
|
|
Health economical aspects, measuring hospital costs, patient costs, primary health service costs, and performing cost-utility analyses.
Time Frame: Postoperatively: 3 months, 6 months, 1 year, 2 years
|
Postoperatively: 3 months, 6 months, 1 year, 2 years
|
|
Adjacent level disc disease, measured by use of MRI scans.
Time Frame: Maximum 4 months preoperatively. Postoperatively:1 year, 2 years, 5 years
|
Maximum 4 months preoperatively. Postoperatively:1 year, 2 years, 5 years
|
|
Preservation of cervical translational and rotational segmental motion, disc height and dorsoventral displacement, by use of functional X-rays with Distortion Compensated Roentgen Analysis (DCRA)
Time Frame: Preoperatively. Postoperatively: 1 day, 6 weeks, 1 year, 2 years, 5 years
|
Preoperatively. Postoperatively: 1 day, 6 weeks, 1 year, 2 years, 5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Øystein P Nygaard, Professor MD, Department of Neurosurgery, St. Olavs Hospital
Publications and helpful links
General Publications
- Sundseth J, Jacobsen EA, Kolstad F, Sletteberg RO, Nygaard OP, Johnsen LG, Pripp AH, Andresen H, Fredriksli OA, Myrseth E, Zwart JA. Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT). Eur Spine J. 2016 Jul;25(7):2271-8. doi: 10.1007/s00586-016-4549-6. Epub 2016 Apr 9.
- Sundseth J, Fredriksli OA, Kolstad F, Johnsen LG, Pripp AH, Andresen H, Myrseth E, Muller K, Nygaard OP, Zwart JA; NORCAT study group. The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion-a prospective, single-blinded, randomized, controlled multicenter study. Eur Spine J. 2017 Apr;26(4):1225-1235. doi: 10.1007/s00586-016-4922-5. Epub 2016 Dec 23.
- Johansen TO, Sundseth J, Fredriksli OA, Andresen H, Zwart JA, Kolstad F, Pripp AH, Gulati S, Nygaard OP. Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy: A Randomized Clinical Trial. JAMA Netw Open. 2021 Aug 2;4(8):e2119606. doi: 10.1001/jamanetworkopen.2021.19606.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 4.2008.211 (REK)
- 18809/2/AMS (Other Identifier: NSD)
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