- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01324622
Comparison of Cervical Laminectomy to Laminoplasty
Comparison of Cervical Laminectomy to Cervical Laminoplasty* in Patients With Cervical Myelopathy or Myeloradiculopathy Due to Multiple Level Cervical Spinal Canal Stenosis * ARCH™ Fixation System by SYNTHES
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Historically, cervical laminectomy has been proven to be effective in the treatment of symptomatic patients with cervical myelopathy. This standard procedure is employed to accomplish posterior decompression of the cervical spinal cord in patients with multi-level cervical spinal stenosis who have normal or near normal cervical spinal curvature and alignment without associated instability. Laminoplasty was developed in Japan as an alternative to the laminectomy procedure with the intent to reduce post-operative morbidity after dorsal cervical spinal cord decompression, neck pain and to maintain the relative stability of the cervical spine after multi-level decompression.
The goal of both the laminoplasty and laminectomy procedures is to provide spinal cord decompression by enlargement of the spinal canal. A potential benefit of laminoplasty compared to laminectomy is to preserve stability and range of motion of the cervical spine without complete disruption/removal of the posterior laminae, spinous processes and interspinous ligamentous structures. Various authors have described different laminoplasty techniques; all preserve the lamina and expand the size of the spinal canal by fixing the freed or partially freed lamina in a more posterior position.
The primary study hypothesis is that, patients treated with laminoplasty with ARCH fixation (Treatment Group) have clinical and radiographic outcomes as assessed by valid outcomes measures, is not inferior to patients treated with laminectomy (Control Group)
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Beverly Hills, California, United States, 90211
- Tower Orthopaedics
-
-
Connecticut
-
New Haven, Connecticut, United States, 06520
- Yale University School Of Medicine
-
-
Missouri
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Kansas City, Missouri, United States, 64132
- Research Medical Center
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Saint Louis, Missouri, United States, 63110
- Washington University School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: All must be met for inclusion in the study.
- The patient must be at least 18 years of age and have no evidence of developmental anomaly of the cranial cervical junction and/or cervical spine
- The patient has the diagnosis of cervical myelopathy
- The myelopathy or myeloradiculopathy requires a posterior cervical decompression of the spinal canal involving two or more contiguous intervertebral levels including and between C3 and C7
- The patient signs the study informed consent form.
Exclusion Criteria:
- Primary symptoms and signs of cervical radiculopathy (only) without myelopathy.
- Presence of primary focal anterior compression of the cervical spinal cord.
- Ossification of the ligamentum flavum.
- Previous surgery of the cervical spine.
- Tumor, infection, or trauma of the cervical spine or cord.
- Segmental instability - Pregnant or interested in becoming pregnant during the study follow-up period.
- Known sensitivity to device materials.
- Currently being treated or intends to be treated postoperatively with other devices for the same disorder (e.g., electrical stimulation devices, pain control devices, etc.).
- Currently a participant in any other study related to the treatment of cervical spinal disorders.
- Prisoner
- Mentally incompetent, or unable to comply with the follow up regime
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Laminectomy
Control
|
standard procedure
|
Active Comparator: Laminoplasty
Treatment group
|
Utilizing the ARCH Fixation System (Study device)
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Imrovement in Modified Japanese Orthopaedic Assessment (mJOA) Recovery Rate
Time Frame: 12 months
|
Number of participants who have mJOA Recovery Rate ≥0%.
mJOA Recovery Rate is defined as: mJOA Recovery Rate = ((PostOp Score-PreOp Score)/(17 - Pre-Op Score))*100
|
12 months
|
Sagittal Angle Success
Time Frame: 12 months
|
Success defined as ≤ +15º (kyphosis) as indicated by a neutral lateral radiograph
|
12 months
|
Incidence of Surgical Interventions
Time Frame: up to 24 months
|
Success defined as a lack of revision, removal or addition of supplemental fixation.
|
up to 24 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Pain Scores on the Visual Analog Scale
Time Frame: Up to 24 months
|
Up to 24 months
|
Functional Improvement Using the Neck Disability Index (NDI)
Time Frame: up to 24 months
|
up to 24 months
|
Quality of Life Improvement Using the SF-12 Scale
Time Frame: up to 24 months
|
up to 24 months
|
Motor Deficit
Time Frame: up to 24 months
|
up to 24 months
|
Reflex Evaluation
Time Frame: up to 24 months
|
up to 24 months
|
Sensory Deficit
Time Frame: up to 24 months
|
up to 24 months
|
Range of Motion
Time Frame: up to 24 months
|
up to 24 months
|
Sagittal Canal Diameter
Time Frame: up to 24 months
|
up to 24 months
|
Extent of Spinal Canal/Cord Decompression
Time Frame: up to 24 months
|
up to 24 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Carl Lauryssen, MD, Tower Orthopaedics
- Principal Investigator: Daniel Riew, MD, Washington University School of Medicine
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2442
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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