"Lumbar Operatively Inserted PerQdisc Artificial Implant Following Nulcectomy" (LOPAIN2) (LOPAIN2)

This study will be a prospective, open-label, multi-center study including 72 patients that will collect additional safety and efficacy data for the Spinal Stabilization Technologies PerQdisc Nucleus Replacement System.

Study Overview

• Status: Recruiting
• Conditions: Chronic Low-back Pain; Degenerative Disc Disease
• Intervention / Treatment: Device: PerQdisc Nucleus Replacement System

Detailed Description

This study will be a prospective, open-label, multi-center study that will collect additional safety and efficacy data for the minimally invasive PerQdisc Nucleus Replacement Device (NRD). Patients will have degenerative disc disease (DDD) in one or more lumbar discs. The NRD is used for surgical replacement of a single nucleus pulposus between spinal lumbar discs L1-S1 using any standard anterior, standard lateral, or minimally invasive posterolateral surgical approach. Currently the surgical gold standard involves spinal fusion of the affected vertebral bodies, reducing range of motion and increasing stress on other vertebral bodies. The goal of nucleus replacement is to reduce chronic low back pain by maintaining disc height while preserving range of motion.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Molly Bond; Phone Number: 1 (715) 577-7527; Email: mbond@sstspine.com
• Study Contact Backup: Name: Maren Lange; Phone Number: 8004841588; Email: mlange@sstspine.com

Study Locations

• Colombia
  • Antioquia
    • Medellín, Antioquia, Colombia
      • Active, not recruiting
      • CIGE: Centro de Imunologia y Genetica
    • Medellín, Antioquia, Colombia
      • Active, not recruiting
      • Fundación Hospitalaria San Vicente de Paul
  • Atlántico
    • Barranquilla, Atlántico, Colombia
      • Active, not recruiting
      • Cediul S.A.
    • Barranquilla, Atlántico, Colombia
      • Withdrawn
      • Fundación Campbell
    • Barranquilla, Atlántico, Colombia
      • Withdrawn
      • Sabbag Radiólogos S.A.
  • D.C.
    • Bogotá, D.C., Colombia
      • Active, not recruiting
      • Sociedad de Cirugia de Bogota- Hospital de San Jose
  • Valle del Cauca Department
    • Cali, Valle del Cauca Department, Colombia
      • Active, not recruiting
      • Clínica Imbanaco de Cali S.A.
• Panama
  • Provincia de Panamá
    • Panama City, Provincia de Panamá, Panama
      • Recruiting
      • Pacífica Salud Hospital Punta Pacífica
      • Principal Investigator: Dr. Ricardo Bermudez, MD
      • Contact: C&M Research S.A.; Phone Number: +507 6860-4953; Email: info@candmresearch.org
• Paraguay
  • Asunción, Paraguay, 1101
    • Recruiting
    • Sanatario Americano
    • Contact: Carlos Cetraro; Email: radiosolutionspy@gmail.com
    • Principal Investigator: Francisco Duarte, MD
• Uzbekistan
  • Tashkent, Uzbekistan
    • Recruiting
    • Republican Specialized Scientific Practical Medical Center of Endocrinology named after Academician Y.Kh. Turakulova
    • Principal Investigator: Dr. Abdufarrukh Karimov

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient is skeletally mature aged 22-70.
• Patient has Degenerative Disc Disease (DDD) at one or more levels between L1 and S1 but the discogenic pain must be limited to a single level.
• Patient has adequate disc height (6mm) at the level to be treated
• Patient has exhausted a minimum of 6 months of conservative treatment for their back (e.g. physical therapy, medications, injections, life style changes, etc).
• Patient has a preoperative Oswestry Disability questionnaire score ≥ 40 out of 100 points (40/100)
• Patient has a low back pain Visual Analog Scale (VAS) ≥ 40 mm (4 cm)
• Patient has signed the approved Informed Consent Form.
• All surgeries must be approved by the Medical Advisory Board (MAB)

Exclusion Criteria:

• Patient has less than 6 mm of disc height.
• Patient has had prior lumbar spine surgery (nucleoplasty at non-index level is considered acceptable).
• Patient has had spinal fusion in the lumbar or thoracic intervertebral spaces. Cervical fusion is allowed as long as there are no neurologic deficits in the lower extremities.
• Patient has spondyloarthropathy or other spondylolisthesis greater than 2 mm.
• Patient has congenital moderate or severe spinal stenosis or epidural lipomatosis.
• Patient has significant facet disease. Significant is defined as pain improvement of 80% or more following image-guided medial branch blocks of the target level according to SIS guidelines (diagnostic, contrast controlled).
• Patient has any known active malignancy.
• Patient has previously undergone or currently on immunosuppressive therapy. Steroids used to treat inflammation are allowed.
• Patient has active or local systemic infection.
• Patient has been diagnosed with hepatitis, rheumatoid arthritis, lupus erythematosus, or other autoimmune disease including AIDS, ARC and HIV.
• Patient has diabetes mellitus (Type 1 or 2) requiring daily insulin management.
• Patient has osteopenia of the spine (T-score of -1.0 or lower). A DEXA scan should be performed to rule out patients considered at risk for osteopenia.
• Patient has morbid obesity defined as a body mass index (BMI) more than 40 or a weight of more than 45 kg (100 lbs.) over ideal body weight.
• Patient has a known allergy to silicone or barium sulfate.
• Patient has a significant disc herniation at the level to be treated. Significant is defined as a large, extruded herniation that creates a risk for expulsion.
• Patient has a significant Schmorl's node in the level to be treated. Significant is defined as a large, rectangular or irregular shaped node that has an associated active inflammatory process (Modic I changes).
• Patient has motion of less than 3 degrees on pre-operative lateral flexion/extension radiographs.
• Patient belongs to a vulnerable population or has a condition such that his/her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised (e.g. developmentally, disabled, prisoner, chronic alcohol/ substance abuser)

Intraoperative Exclusion Criteria:

• Protrusion of the 20A Imaging Balloon up to or beyond the outer margin of the vertebra during the imaging steps.
• Patient has a violated endplate as determined by imaging balloons during fluoroscopy.
• Patient has a disc space that is too narrow for implantation. MIPL Specific
• Poor radiological visualization of Kambin's triangle.
• Sustained irritation of the exiting nerve root during any aspect of the annular dilation technique (leg movement or if performing with electrical monitoring) in spite or repositioning instruments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lumbar Disc Nucleus Replacement; All patients meeting all inclusion criteria and no exclusion criteria will be considered for nucleus replacement surgery following a review by the Medical Advisory Board.	Device: PerQdisc Nucleus Replacement System; Lumbar spine disc nucleus replacement system. All patients meeting all inclusion criteria and no exclusion criteria will be considered for nucleus replacement surgery following a review by the Medical Advisory Board.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perfromance: ODI	Change in in Oswestry Disability Index (ODI) comparing baseline to follow up visits using a patient-reported outcome tool	6 months
Perfromance: ODI	Change in in Oswestry Disability Index (ODI) comparing baseline to follow up visits using a patient-reported outcome tool	12 months
Performance: VAS	Change in back pain as measured by the 100 - millimeter Visual Analog Scale (VAS)	6 months
Performance: VAS	Change in back pain as measured by the 100 - millimeter Visual Analog Scale (VAS)	12 months
Safety: Expulsion & Device Failure	Incidence of device expulsion and device failure following surgery based on follow up X-rays and MRI's	6 months
Safety: Expulsion & Device Failure	Incidence of device expulsion and device failure following surgery based on follow up X-rays and MRI's	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety: Revision Surgery	Incidence of revision surgery	6 months, 12 months, and 5 years
Safety: Expulsion & Device Failure	Incidence of device expulsion and device failure following surgery based on follow up X-rays and MRI's	5 years
Performance: Disc Height	Preservation of intervertebral disc height (in mm) as measured on MRI post-surgery compared to baseline	6 months, 12 months, and 5 years
Performance: RoM	Preservation of range of movement (expressed in degrees) at the index and adjacent levels at baseline compared to follow-up using flexion/extension radiographs	6 months, 12 months, 5 years
Safety: Neurological Status	Maintenance of baseline neurologic status through physical assessment evaluating nerve compression at baseline and post-surgical follow-up using pain, motor strength, and sensation feedback from the patient on a 0 (no compression) to 5 (major compression) scale	6 months, 12 months, and 5 years
Performance: Analgesic Score	Change in level of pain medication used comparing baseline to follow up visits based on a medication scale ranging from 0 (no meds) - 4 (high dose opioids)	6 months, 12 months, and 5 years
Safety: SAE	Incidence of serious adverse events that are related to the surgical procedure or Incidence of Serious Adverse Events related to the surgical procedure or device	6 months, 12 months, and 5 years

Collaborators and Investigators

• Sponsor: Spinal Stabilization Technologies
• Investigators: Study Chair: Michael Hess, MD, London Spine Clinic/ATOS-Klinik

Study record dates

Study Major Dates

• Study Start (Actual): August 22, 2022
• Primary Completion (Estimated): August 22, 2027
• Study Completion (Estimated): August 22, 2030

Study Registration Dates

• First Submitted: August 1, 2022
• First Submitted That Met QC Criteria: August 17, 2022
• First Posted (Actual): August 19, 2022

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 25, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Low Back Pain; DDD; Degenerative Disc Disease; Chronic Low Back Pain; Disc Herniation; cLBP; Nucleus Replacement
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Bone Diseases; Musculoskeletal Diseases; Pathological Conditions, Anatomical; Spinal Diseases; Hernia; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Intervertebral Disc Displacement; Low Back Pain; Intervertebral Disc Degeneration
• Other Study ID Numbers: LOPAIN2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No