- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03941327
Do AxoGuard Implants Decrease Shoulder Disability After Neck Dissections
May 6, 2019 updated by: University of Mississippi Medical Center
The purpose of this study is to determine whether Axoguard nerve protectors have a role in preventing shoulder disability and pain following spinal accessory nerve sparing neck dissections.
Study Overview
Status
Unknown
Intervention / Treatment
Detailed Description
The spinal accessory nerve is often manipulated during selective neck dissections in order to remove the fibrofatty tissues containing lymph nodes surrounding the nerve.
Afterwards the nerve is left exposed without it's normal support making it vulnerable to adhesions, compression, and stretch injury.
Axoguard nerve wraps have shown significant promise in preventing the recurrence of carpal tunnel following forearm surgery, and preventing impotence and incontinence following nerve sparing robotic radical prostatectomy.
The investigators hypothesize that the same technology may aid in reducing shoulder disability and pain if used in spinal accessory nerve sparing neck dissections.
In this prospective single blinded randomized controlled study the investigators will randomly assign patients to a control group that will not receive the AxoGuard nerve wrap, and a study group that will receive the AxoGuard nerve wrap around their exposed spinal accessory nerve(s) using a research randomization tool.
The results will be stratified into groups including preoperative and postoperative stage of disease, preoperative and postoperative nodal (neck) stage, history of radiation, and whether or not level 2B was dissected.
Individuals with a history of pre-existing disabling shoulder complaints, individuals under the age of 18, individuals who cannot provide their own informed consent, and individuals undergoing a neck dissection that will remove the sternocleidomastoid muscle or spinal accessory nerve will be excluded from the study.
Patients will undergo preoperative shoulder assessment using the Constant-Murley shoulder outcome score at their initial clinical visit.
Postoperative outcomes will be recorded at 2 weeks, 2 months, 4 months, and 6 months and measured by the Shoulder Disability Questionnaire, Rand-36 quality of life survey, pain scale, and Constant-Murley shoulder outcome score.
With this study the investigators aim to show a clinically significant improvement in shoulder function following spinal accessory nerve sparing neck dissections when AxoGuard nerve wraps are used to protect the nerve.
Additionally, the investigators aim to improve patient satisfaction, decrease post-op pain, and improve quality of life.
Study Type
Interventional
Enrollment (Anticipated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Jaxon W Jordan, M.D.
- Phone Number: 325-370-2063
- Email: jwjordan@umc.edu
Study Contact Backup
- Name: Gina Jefferson, M.D.
- Phone Number: 3124339898
- Email: gjefferson@umc.edu
Study Locations
-
-
Mississippi
-
Jackson, Mississippi, United States, 39216
- Recruiting
- University of Mississippi Medical Center
-
Contact:
- Gina Jefferson
- Phone Number: 312-433-9898
- Email: gjefferson@umc.edu
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
-Any neck dissection (cervical lymphadenectomy) that involves resection of level 2 cervical lymph nodes for malignancy and does not fall into the categories listed under the exclusion criteria.
Exclusion Criteria:
- History of modified radical neck dissection involving removal of spinal accessory nerve or sternocleidomastoid muscle
- History of radical neck dissection
- History of pre- existing disabling shoulder complaints
- <18 years of age
- Any individual unable to provide consent for his/her self.
- Any individual with allergy, sensitivity, or aversion to porcine material.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Control
Patients who provide consent for implant placement but do not receive the implant.
|
A porcine collagen implant will be used to make a protective sheath around the participant's exposed spinal accessory nerve during surgery.
This will be performed by physically wrapping the exposed nerve with the implant and suturing the ends together.
The goal is to protect nerve from adhesions and compression in the absence of normal protective lymphatic soft tissue.
|
Experimental: Interventional
Patients who provide consent for implant placement and do receive the implant.
|
A porcine collagen implant will be used to make a protective sheath around the participant's exposed spinal accessory nerve during surgery.
This will be performed by physically wrapping the exposed nerve with the implant and suturing the ends together.
The goal is to protect nerve from adhesions and compression in the absence of normal protective lymphatic soft tissue.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Shoulder function
Time Frame: The comparison of improvement or change in shoulder function over 6 months between the control and intervention groups will be the primary outcome measure.
|
Shoulder function will be assessed by Constant-Murley shoulder scale.
The Constant-Murley shoulder scale is a validated subjective and objective survey of overall shoulder function.
The scale ranges from 0 (no shoulder function) to 100 (perfect shoulder function).
It consists of several questions about pain and disability as well as actual shoulder testing that will be performed by the consenting physician during the participant's clinic appointment.
|
The comparison of improvement or change in shoulder function over 6 months between the control and intervention groups will be the primary outcome measure.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postoperative pain following neck dissection: rate shoulder pain from 1-10
Time Frame: Patients will be asked to rate shoulder pain from 1-10 at each postoperative visit over the course of 6 months.
|
The comparison of the improvement or change in pain scores over 6 months between the control group and intervention group will be assessed at each clinical visit over the course of 6 months.
|
Patients will be asked to rate shoulder pain from 1-10 at each postoperative visit over the course of 6 months.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 1, 2019
Primary Completion (Anticipated)
May 1, 2020
Study Completion (Anticipated)
May 1, 2020
Study Registration Dates
First Submitted
May 1, 2019
First Submitted That Met QC Criteria
May 6, 2019
First Posted (Actual)
May 7, 2019
Study Record Updates
Last Update Posted (Actual)
May 7, 2019
Last Update Submitted That Met QC Criteria
May 6, 2019
Last Verified
May 1, 2019
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2018-0212
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Undecided
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
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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