Comparison of the Aspen Device Versus Pedicle Screws for Supplemental Posterior Fixation in Lumbar Interbody Fusion
A Multi-Center Prospective Randomized Study Comparing Supplemental Posterior Instrumentation, Aspen™ Spinous Process System Versus Pedicle Screw Fixation, in Lateral Lumbar Interbody Fusion (LLIF) or Anterior Lumbar Interbody Fusion (ALIF)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a multi-center, prospective randomized clinical study to evaluate the clinical outcome of subjects with degenerative disc disease (DDD) (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies) and/or spondylolisthesis utilizing either Aspen Spinous Process Fixation System or Pedicle Screws for supplemental posterior instrumentation as an adjunct to an anterior or lateral approach to lumbar interbody fusion.
The primary hypothesis is that change in Oswestry Disability Index (ODI) of subjects in the study group (Aspen) will be non-inferior to the control group (pedicle screw instrumentation). The non-inferiority margin is pre-specified to be 10 ODI score points. If the non-inferiority is established, superiority of Aspen to the control will be tested.
The study will involve up to 25 investigational sites. Enrollment is expected to take approximately 24 months. Subjects will be followed for 2 years, with the anticipated duration of the study being approximately 4 years from start to finish.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Kentucky
-
Paducah, Kentucky, United States, 42001
- Clint Hill
-
-
New York
-
Lockport, New York, United States, 14094
- Buffalo Spine Surgery
-
-
Oregon
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Medford, Oregon, United States, 97504
- Andy Kranenburg
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age between 18 and 75 years
- Scheduled for an elective single-level circumferential lumbar fusion by means of supplemental posterior fusion with fixation (allowing for the placement of ASPEN or pedicle screws) for an anterior or lateral interbody fusion
- Diagnosis of primary symptomatic Degenerative Disc Disease (DDD) and/or spondylolisthesis confirmed with appropriate imaging studies and/or positive lumbar discography
- Oswestry Disability Index (ODI) v2.1 score > 30%
- Failed at least 3 months of conservative care (non-surgical) OR has clinical signs of neurological deterioration
- Signed Informed Consent Form
Exclusion Criteria:
- Previous fusion at the operative level
- Spondylolisthesis Grade 3 or more
- Lytic spondylolisthesis
- Incompetent or missing posterior arch at the affected level (e.g. complete laminectomy, pars defect)
- Requires complete laminectomy at level of surgery
- Facet joints at implant level are absent or fractured
- Vertebral body compromise or acute fracture at implant level
- Body mass Index (BMI) ≥ 35
- Known allergy to titanium
- Osteoporosis: Simple Calculated Osteoporosis Risk Estimation (S.C.O.R.E.) > 6 AND Dual-energy X-ray absorptiometry (DEXA) T-score < -2.5
- Paget's disease, osteomalacia, or any other metabolic bone disease
- Use of medications or any drug known to potentially interfere with bone/soft tissue healing (e.g. chronic systemic steroids)
- Planned use of additional segmental fixation (eg. facet screws)
- Planned use of Bone Morphogenetic Protein (BMP) for posterolateral fusion*
- Unlikely to comply with the follow-up evaluation schedule
- In the opinion of the Investigator, Subject has history of chemical substance dependency or significant psychosocial disturbance that may impact the outcome or study participation
- Active participation in a clinical trial of another drug or device
- Active systemic infection or any other health condition that would preclude surgery
- History of invasive malignancy, except if the subject has received treatment and displayed no clinical signs and symptoms for at least five years
- Subject is a prisoner
- Pregnant or planning to become pregnant during the length of study participation
- Involvement in active litigation related to back problems at the time of screening
- Direct involvement in the execution of this protocol
- Pre-existing conditions that could interfere with the evaluation of outcome measures (e.g. musculoskeletal, neuromuscular, etc.)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Aspen Spinous Process Fixation Device
Subjects randomized to the Aspen study arm will have the Aspen device implanted as supplemental posterior fixation only and according to the manufacturer's recommendations.
|
The Aspen device will be placed as posterior fixation to Lateral Lumbar Interbody Fusion (LLIF) or Anterior Lumbar Interbody Fusion (ALIF)
|
|
Active Comparator: Pedicle Screws
Subjects randomized to the pedicle screw group will have polyaxial top loading pedicle screws implanted according to the standard procedures and practices at that institution.
The procedure may be performed according to surgeon preference, including a traditional open, minimally invasive or percutaneous approach.
Only pedicle screws cleared by FDA for this indication will be used in this study.
|
Pedicle Screws will be placed as posterior fixation to Lateral Lumbar Interbody Fusion (LLIF) or Anterior Lumbar Interbody Fusion (ALIF)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Absolute change in Oswestry Disability Index (ODI)
Time Frame: baseline to 12 months post-operative
|
baseline to 12 months post-operative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Pain medication usage
Time Frame: Baseline, surgery, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
Baseline, surgery, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
|
Change in EQ-5D-3L
Time Frame: Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
|
Change in Zurich Claudication Questionnaire
Time Frame: Baseline, 12 months & 24 months
|
Baseline, 12 months & 24 months
|
|
Fusion success
Time Frame: 12 months and 24 months
|
12 months and 24 months
|
|
Neurological status
Time Frame: Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
|
Change in SF-36
Time Frame: Baseline, 12 months & 24 months
|
Baseline, 12 months & 24 months
|
|
Change in Visual Analogue Scale (VAS) (pain)
Time Frame: Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
Baseline, 6 weeks, 3 months, 6 months, 12 months, & 24 months
|
|
Operative parameters (estimate blood loss, fluor time, length of hospital stay)
Time Frame: Intraoperative
|
Intraoperative
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Patel, University of Colorado, Denver
- Principal Investigator: Cappuccino, Buffalo Spine Surgery
Study record dates
Study Major Dates
Study Start
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- ASP-11-001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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