- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04743869
Calcium Phosphate Versus PMMA Cement in Thoracolumbar Fractures (CaPvsPMMA)
February 3, 2021 updated by: Medical University of Graz
Calcium Phosphate Versus PMMA Cement in Unstable Thoracolumbar Burst Fractures Treated With Dorsal Instrumentation in Patients > 50 Years of Age Randomized Controlled Non-inferiority Trial Design
Patients at the age of 50 or older presenting with thoracolumbar fractures including segments TH 6-L5 and A3/A4 fractures according to the AO Spine fracture classification after the acute trauma and planned surgery within 3 weeks following trauma will be asked to participate in a randomized trial in which they will receive either Calciumphosphate (CaP) or Polymethylmethacrylate (PMMA) as part of a standardized treatment approach.
Regardless of the group patients are randomized to, all participating patients undergo the same surgical procedure except for the preparation and administration of bone cement.
The study participation period for each patient is 1 year from the date of the surgery and includes 4 defined time points that include follow-up clinical visits for imaging and progress checks at 6 weeks, 3 months, 6 months and 12 months after surgery.
At each follow-up visit, a combination of questionnaires and radiological imaging will be performed to assess general health status, disability level and pain control, as well as objective results of the surgery.
The main outcome measure will be the loss of correction rate that will be measured through the bi-segmental COBB angle presented in the CT-scan.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
85
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: Gloria Hohenberger, Assist.Prof.
- Phone Number: +43 316 385 81721
- Email: gloria.hohenberger@medunigraz.at
Study Contact Backup
- Name: Marina Bergovec, Dr. Sc.
- Phone Number: +43 316 385 87436
- Email: marina.bergovec@medunigraz.at
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
50 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Written consent of the participant after being informed
- Acute trauma (surgery within three weeks following trauma)
- Thoracolumbar fractures including segments TH 6-L5
- A3/A4 fractures according to the AO Spine fracture classification
- Patient age ≥ 50 years
- Minimum follow up 1 year
Exclusion Criteria:
- Presence of neurological deficits at the time of surgery
- Pathological fractures (bone metastases)
- Traumatic brain injury
- Ankylosing spondylitis as a comorbidity
- Pregnancy
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: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: KYPHON® ActivOs™10 Bone Cement with hydroxyapatite
As a reference device KYPHON® ActivOs™10 Bone Cement with hydroxyapatite (Medtronic) for treatment of vertebral compression fractures will be used.
It is a polymethylmethacrylate (PMMA) bone cement containing hydroxyapatite (HA) for use in the treatment of patients with vertebral compression fractures (VCFs) who are undergoing minimally invasive surgery with KYPHON® Balloon Kyphoplasty.
This bone substitute has already been approved and is in use in the patients at the age of 50 or older.
|
Dorsal instrumentation via Longitude II (Medtronic Austria GmbH/Vienna) and balloon kyphoplasty are performed.
KYPHON ActivOs® Bone Cement with Hydroxyapatite will be introduced in the fractured vertebral body.
Other Names:
|
Experimental: KyphOs FS™
The test device KyphOs FS™ will be used in patients at the age of 50 and older in order to prove its superiority over the currently used PMMA bone cement.
|
Dorsal instrumentation via Longitude II (Medtronic Austria GmbH/Vienna) and balloon kyphoplasty are performed.
KyphOs FS™ bone cement will be introduced in the fractured vertebral body.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change in correction rates when using CaP
Time Frame: Preoperatively (determination of fracture classification), postoperatively (immediately following surgery), 1 year postoperatively
|
The main outcome measure 1 will be the loss of correction rate that will be measured through the bi-segmental COBB angle presented in the CT-scan.
The Cobb angle will be measured between the superior end plate of the vertebral body cephalad to the injury and the inferior end plate of the vertebral body caudal to the injury.
|
Preoperatively (determination of fracture classification), postoperatively (immediately following surgery), 1 year postoperatively
|
The change in correction rates when using PMMA
Time Frame: Preoperatively (determination of fracture classification), postoperatively (immediately following surgery), 1 year postoperatively
|
The main outcome 2 measure will be the loss of correction rate that will be measured through the bi-segmental COBB angle presented in the CT-scan.
The Cobb angle will be measured between the superior end plate of the vertebral body cephalad to the injury and the inferior end plate of the vertebral body caudal to the injury.
Measurements will be taken from CT scans.
|
Preoperatively (determination of fracture classification), postoperatively (immediately following surgery), 1 year postoperatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change in vertebral body height when using CaP
Time Frame: Preoperatively, postoperatively (immediately following the surgery), 1 year postoperatively
|
The percentage loss of the vertebral body height will be calculated by dividing the height of the fractured vertebra by the average height of the cephalad and caudad vertebrae and then subtracting this number from 100%.
Measurements will be taken from CT scans.
|
Preoperatively, postoperatively (immediately following the surgery), 1 year postoperatively
|
The change in vertebral body height when using PMMA
Time Frame: Preoperatively, postoperatively (immediately following the surgery), 1 year postoperatively
|
The percentage loss of the vertebral body height will be calculated by dividing the height of the fractured vertebra by the average height of the cephalad and caudad vertebrae and then subtracting this number from 100%.
|
Preoperatively, postoperatively (immediately following the surgery), 1 year postoperatively
|
Changes in complication rates when using PMMA
Time Frame: 6 weeks, 3 months, 6 months and 12 months postoperatively
|
The occurence of the complication rates, in particular cement extravasation and temporary fall in blood pressure, will be compared between the two groups for each time point using the Student´s t-test for independent samples.
In addition, a paired Student´s t-test will be performed within each group in order to evaluate the differences in means of the secondary endpoints measured at the defined timepoints.
|
6 weeks, 3 months, 6 months and 12 months postoperatively
|
Changes in complication rates when using CaP
Time Frame: 6 weeks, 3 months, 6 months and 12 months postoperatively
|
The occurence of the complication rates, in particular cement extravasation and temporary fall in blood pressure, will be compared between the two groups for each time point using the Student´s t-test for independent samples.
In addition, a paired Student´s t-test will be performed within each group in order to evaluate the differences in means of the secondary endpoints measured at the defined timepoints.
|
6 weeks, 3 months, 6 months and 12 months postoperatively
|
Change in the disability on the ODI rating scale in patients with PMMA
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
ODI is mainly used in spine trauma patients.
A score of 0% to 20% indicates minimal disability; 21% to 40%, moderate disability; and 41% to 60% severe disability.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Change in the disability on the ODI rating scale in patients with CaP
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
ODI is mainly used in spine trauma patients.
A score of 0% to 20% indicates minimal disability; 21% to 40%, moderate disability; and 41% to 60% severe disability.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Change in pain on the spine VAS in patients with PMMA
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
VAS - Spine Visual Analogue Scale is a measurement that measures pain intensity and it is completed by patients themselves.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Change in pain on the spine VAS in patients with CaP
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
VAS - Spine Visual Analogue Scale is a measurement that measures pain intensity and it is completed by patients themselves.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Change in quality of life in patients with PMMA measured by the 36-item Short Form Survey
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
The 36-Item Short Form Survey (SF-36) will be used to assess patient´s self-reported quality of life.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Change in quality of life in patients with CaP measured by the 36-item Short Form Survey
Time Frame: Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
The 36-Item Short Form Survey (SF-36) will be used to assess patient´s self-reported quality of life.
|
Five times - after the surgery, at each study visit (6 weeks, 3 months, 6 months and 12 months postoperatively)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Paul Puchwein, Assist.Prof., University Hospital Graz
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 (Anticipated)
February 1, 2021
Primary Completion (Anticipated)
February 1, 2024
Study Completion (Anticipated)
February 1, 2024
Study Registration Dates
First Submitted
February 3, 2021
First Submitted That Met QC Criteria
February 3, 2021
First Posted (Actual)
February 8, 2021
Study Record Updates
Last Update Posted (Actual)
February 8, 2021
Last Update Submitted That Met QC Criteria
February 3, 2021
Last Verified
February 1, 2021
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- V 2.0
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
IPD Plan Description
Results of the study are planned to be made public within a scientific work.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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