Postmarketingundersøgelse af MagnetOs kit sammenlignet med autograft hos patienter, der gennemgår posterolateral lumbalfusion (PROOF)
En prospektiv, randomiseret, enkeltcenterundersøgelse for at vurdere sikkerheden og ydeevnen af MagnetOs-kit sammenlignet med autograft hos patienter, der gennemgår to-niveau instrumenteret posterolateral lumbal/thoracolumbar fusion (PLF)
This is a phase IV post-marketing study for MagnetOs Easypack Putty. MagnetOs Easypack Putty is a synthetic bone graft extender product that is routinely used by surgeons as a treatment for patients with degenerative disc disease or spinal trauma undergoing spinal fusion surgery.
In this study, MagnetOs Easypack Putty will be used according to the latest U.S. Instructions For Use, standalone in the posterolateral spine.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
In this study, following a screening period of a maximum of 30 days, 60 patients will undergo up to two-level instrumented posterolateral fusion (PLF) procedure. Prior to surgery, each patient will be randomized to receive MagnetOs Easypack Putty standalone on the assigned side of the spine and Demineralized Bone Matrix or Fibers mixed with local autograft bone on the other at the diseased levels. They will be followed up at discharge, Week 2, Month 3, Month 6, and Month 12. An interim analysis will be performed once 30 patients have completed their Month 6 visit and have measurements for the endpoints available to measure effectiveness. The primary endpoint will be analyzed at Month 12.
In this study, MagnetOs Easypack Putty will be applied according to the latest Instructions for Use approved in the United States. Specifically, MagnetOs Easypack Putty will be used standalone in patients up to two-level degenerative disc disease with segmental mechanical spinal instability requiring treatment with an instrumented posterolateral spine fusion procedure. The fusion procedure (PLF) will be left to the surgeon's discretion.
Radiographs will be obtained at Screening, Discharge, Month 3, Month 6 and Month 12. CT scans will only be obtained at Month 6 and Month 12.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
California
-
Irvine, California, Forenede Stater, 92697
- The Regents of the University of California- Irvine Campus
-
-
Michigan
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Grand Rapids, Michigan, Forenede Stater, 49503
- Corewell Health
-
-
Missouri
-
St Louis, Missouri, Forenede Stater, 63130
- The Washington University
-
-
Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19107
- Rothman Orthopaedic Institute
-
-
Tennessee
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Nashville, Tennessee, Forenede Stater, 37209
- Tennessee Orthopaedic Alliance
-
-
Washington
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Seattle, Washington, Forenede Stater, 98104
- University of Washington
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Patient is able to read/be read, understand, and provide written informed consent and has signed the Institutional Review Board (IRB) approved informed consent.
- Male or female patient ≥ 18 years old.
- Patients with segmental mechanical spinal instability requiring arthrodesis surgery.
Instability can be either caused by degenerative disc disease or by traumatic injury to the spinal column. Patient requiring a maximum of two-level instrumented posterolateral lumbar/thoraco-lumbar fusion (T11 - S1) will be enrolled. Mechanical instability is defined by the presence of one or more of the following:
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instability (angulation ≥ 5 degrees or translation ≥ 3 mm on flexion/extension radiographs),
-
decreased disc height by > 2 mm, but dependent upon the spinal level
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Grade II or more listhesis
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TLICS equal or greater than 5
-
Unstable burst fracture
- Failed conservative treatment (physical therapy, bed rest, medications, spinal injections, manipulations, or transcutaneous electrical nerve stimulation) for a minimum period of 3 months prior to study enrollment (if the patient undergoes elective surgery). Patients who have spinal instability (as defined above in inclusion criteria number three), caused by acute trauma requiring urgent surgical treatment are excluded from this criterion.
Exclusion Criteria:
- Requires > two-level fusion or expected to need secondary intervention within one year following surgery.
- Had prior PLF fusion or attempted PLF fusion at the involved levels.
- Had previous decompression at the involved levels.
- Women who are or intend to become pregnant within the next 12 months.
- To treat conditions in which general bone grafting is not advisable.
- In conditions where the surgical site may be subjected to excessive impact or stresses, including those beyond the load strength of fixation hardware (e.g. defect site stabilization is not possible).
- In case of significant vascular impairment proximal to the graft site.
- In case of severe metabolic or systemic bone disorders (e.g., osteogenesis imperfecta, history of or active Pott's disease, stage >4 renal disease or Paget's Disease) that affect bone or wound healing.
- In case of acute and chronic infections in the operated area (soft tissue infections; inflammation, bacterial bone diseases; osteomyelitis).
- When intraoperative soft tissue coverage is not planned or possible.
- Receiving treatment with medication interfering with calcium metabolism.
- Has degenerative disc disease (DDD) related to a benign or malignant tumor.
- Has history or presence of active malignancy.
- Has known substance abuse, psychiatric disorder, or a condition which, in the opinion of the investigator, may influence the healing or ability to comply with protocol requirements.
- Is involved in active litigation relating to his/her spinal condition.
- Has participated in an investigational study within 30 days prior to surgery for study devices.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: MagnetOs Easypack Putty
Interventions
|
MagnetOs Easypack Putty used standalone in instrumented posterolateral fusion, 5cc-15c per spine level at the randomized assigned side. |
|
Aktiv komparator: Demineralized Bone Matrix or Fibers (DBX or Grafton) mixed with local autograft bone
Interventions
|
Demineralized Bone Matrix or Fibers (DBX or Grafton) mixed in a 1:1 vol% with local autologous bone graft used in instrumented posterolateral fusion, 5cc-15cc per level mixed with bone marrow aspirate/blood per spine level at the contralateral side. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Radiographic Fusion by CT Scan
Tidsramme: Month 12
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by CT-scan at Month 12. Radiographic as determined by evidence of bridging trabeculae or continuous bony connection between the superior and inferior transverse processes. |
Month 12
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Radiographic Fusion by Plain Radiographs
Tidsramme: Month 6, Month 12
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by plain radiographs. |
Month 6, Month 12
|
|
Radiographic Fusion by CT Scan
Tidsramme: Month 6
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by CT-scan at Month 6. Radiographic as determined by evidence of bridging trabeculae or continuous bony connection between the superior and inferior transverse processes. |
Month 6
|
|
Functional Outcome by Oswestry Disability Index Questionnaire
Tidsramme: Screening, Week 2, Month 3, 6, and 12
|
Functional outcome by the Oswestry Disability Index questionnaire. Patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. The lower the percentage the higher the patient's functionality. 0-20% minimal disability, 80-100% significant disability or bedridden. |
Screening, Week 2, Month 3, 6, and 12
|
|
Back and Leg Pain by Visual Analog Pain Scale Questionnaire
Tidsramme: Screening, Week 2, Month 3, 6, and 12
|
Change in back and leg pain using Visual Analog Pain Scale (0-100). Patient-completed questionnaire scoring pain by using 100 mm line. Zero being no pain, 100 is worst pain imaginable. |
Screening, Week 2, Month 3, 6, and 12
|
|
Neurologic Status by Physical Exam
Tidsramme: Screening, Week 2, Month 3, 6, and 12
|
Change in neurologic status by examination to document stable, improved, or deficits in condition. Stable or improved findings for lower extremities, specifically reflexes, muscle strength, sensory, and straight leg raise. |
Screening, Week 2, Month 3, 6, and 12
|
|
Success Rate
Tidsramme: Week 2, Month 3, 6, and 12
|
Number of patients with secondary surgical interventions (SSI's) such as revisions, re-operations, removals, supplemental fixations, or any other procedure that adjusts or removes part of the original implant configuration with or without replacement of the components within 12 months of surgery. |
Week 2, Month 3, 6, and 12
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Safety Endpoint - number of patients with Adverse Events
Tidsramme: 12 Months
|
The number of patients with Adverse Events from Screening up to Month 12 after surgery. |
12 Months
|
|
Safety Endpoint - number of patients with Serious Adverse Events
Tidsramme: 12 Months
|
The number of patients with Serious Adverse Events from Screening up to Month 12 after surgery |
12 Months
|
|
Safety Endpoint - number of patients with Adverse Device Effects
Tidsramme: 12 Months
|
The number of patients with Adverse Device Effects from Screening up to Month 12 after surgery. |
12 Months
|
|
Safety Endpoint - number of patients with Device Related Complications
Tidsramme: 12 Months
|
The number of patients with any complications considered to device related with 12 months after surgery. |
12 Months
|
|
Health Economic - Duration of Surgery
Tidsramme: 12 Months
|
Duration of surgery in minutes. |
12 Months
|
|
Health Economic - Duration of Hospitalization
Tidsramme: 12 Months
|
Duration of hospital stay in days. |
12 Months
|
|
Health Economic - Return to Work
Tidsramme: 12 Months
|
Time to return to work in days. |
12 Months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Studieleder: Cesar Silva, MD, Kuros BioSciences B.V.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MAG-920-023
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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