- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00266929
Treatment of Type II Odontoid Fractures Among the Elderly
9. august 2017 opdateret af: AOSpine North America Research Network
Comparing Surgical to Conservative Management in the Treatment of Type II Odontoid Fractures Among the Elderly
The purpose of this study is to compare the safety and effectiveness of surgical versus conservative management of type II odontoid fractures among patients > 64 years of age.
Of secondary interest is to determine if there are differences in outcomes between anterior screw fixation and posterior fusion of these fractures.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Hypotheses are as follows:
- Patients receiving surgical management will exhibit better disease specific health and general health related quality of life measures compared to those managed conservatively.
- The rate of radiographic bony fusion will be greater among elderly patients receiving surgical fixation compared to patients receiving conservative management.
- The rate of non union will be greater in the conservative group compared to the surgical group.
- The complication rate will be higher in the surgical group due to the nature of the intervention though the rate of severe and serious complications will be low.
Undersøgelsestype
Observationel
Tilmelding (Faktiske)
159
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Ontario
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Toronto, Ontario, Canada, M5T 258
- Toronto Western Hospital
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Georgia
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Atlanta, Georgia, Forenede Stater, 30329
- Emory University SOM: Orthopedics
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Indiana
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Indianapolis, Indiana, Forenede Stater, 46260
- Indiana Spine Group
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Kansas
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Kansas City, Kansas, Forenede Stater, 66160
- Kansas University Medical Center
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Maryland
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Baltimore, Maryland, Forenede Stater, 21287
- John Hopkins University
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02115
- Brigham and Women's Hospital
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Minnesota
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Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic
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New York
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New York, New York, Forenede Stater, 10021
- Cornell Weill Medical College
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Ohio
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Cleveland, Ohio, Forenede Stater
- Cleveland Clinic
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Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19107
- Spinal Cord Injury Center Thomas Jefferson University and The Rothman Institute
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Tennessee
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Nashville, Tennessee, Forenede Stater, 37232
- Vanderbilt University
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Utah
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Salt Lake City, Utah, Forenede Stater, 84108
- University of Utah
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Virginia
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Charlottesville, Virginia, Forenede Stater, 22908
- University of Virginia
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Washington
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Seattle, Washington, Forenede Stater, 98104
- Harborview Medical Center
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West Virginia
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Morgantown, West Virginia, Forenede Stater, 26506
- West Virginia University
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
64 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ja
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
Subjects receiving care for acute Type II Odontoid Fracture in participating investigational sites
Beskrivelse
Inclusion Criteria:
- All new type II odontoid fractures including those in which the fracture line crosses into the body of C2
- Age > 64
- Stable and unstable fractures
- < 3 months post-injury
- No previous treatment for an odontoid fracture
Exclusion Criteria:
- Pathological fractures unrelated to osteoporosis
- Severe dementia or severe mental health problems
- Participation in other trials or unlikely to attend follow-ups
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
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Surgical
Subjects receiving surgical treatment for Type II odontoid fracture per discretion of investigator (non-randomized allocation)
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surgical treatment of odontoid fractures
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Non-surgical
Subjects treated with non-operative treatment options
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conservative stabilization of fractures
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
---|---|
Compare disease-specific health-related quality of life between the surgically and conservatively managed patients using the neck disability index
Tidsramme: 12 months
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12 months
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Compare the proportion of patients with radiographic bony fusion between the surgically and conservatively managed patients
Tidsramme: 12 months
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12 months
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Compare the rate of non-union between the surgically and conservatively managed patients
Tidsramme: 12 months
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12 months
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Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Compare the rate of complications
Tidsramme: 12 months
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12 months
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Compare the cervical range of motion between patients receiving anterior screw fixation, posterior fusion, and conservative management
Tidsramme: 12 months
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12 months
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Identify risk factors for a poor outcome, independent of treatment intervention
Tidsramme: 12 months
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12 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Alexander R Vaccaro, MD, Thomas Jefferson University and The Rothman Institute
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Smith HE, Kerr SM, Maltenfort M, Chaudhry S, Norton R, Albert TJ, Harrop J, Hilibrand AS, Anderson DG, Kopjar B, Brodke DS, Wang JC, Fehlings MG, Chapman JR, Patel A, Arnold PM, Vaccaro AR. Early complications of surgical versus conservative treatment of isolated type II odontoid fractures in octogenarians: a retrospective cohort study. J Spinal Disord Tech. 2008 Dec;21(8):535-9. doi: 10.1097/BSD.0b013e318163570b.
- Smith HE, Vaccaro AR, Maltenfort M, Albert TJ, Hilibrand AS, Anderson DG, Harrop J, Fehlings MG, Kopjar B, Brodke DS, Arnold PM, Shaffrey CI. Trends in surgical management for type II odontoid fracture: 20 years of experience at a regional spinal cord injury center. Orthopedics. 2008 Jul;31(7):650.
- Vaccaro AR, Kepler CK, Kopjar B, Chapman J, Shaffrey C, Arnold P, Gokaslan Z, Brodke D, France J, Dekutoski M, Sasso R, Yoon ST, Bono C, Harrop J, Fehlings MG. Functional and quality-of-life outcomes in geriatric patients with type-II dens fracture. J Bone Joint Surg Am. 2013 Apr 17;95(8):729-35. doi: 10.2106/JBJS.K.01636.
- Fehlings MG, Arun R, Vaccaro AR, Arnold PM, Chapman JR, Kopjar B. Predictors of treatment outcomes in geriatric patients with odontoid fractures: AOSpine North America multi-centre prospective GOF study. Spine (Phila Pa 1976). 2013 May 15;38(11):881-6. doi: 10.1097/BRS.0b013e31828314ee.
- Chapman J, Smith JS, Kopjar B, Vaccaro AR, Arnold P, Shaffrey CI, Fehlings MG. The AOSpine North America Geriatric Odontoid Fracture Mortality Study: a retrospective review of mortality outcomes for operative versus nonoperative treatment of 322 patients with long-term follow-up. Spine (Phila Pa 1976). 2013 Jun 1;38(13):1098-104. doi: 10.1097/BRS.0b013e318286f0cf.
- Smith HE, Kerr SM, Fehlings MG, Chapman J, Maltenfort M, Zavlasky J, Harris E, Albert TJ, Harrop J, Hilibrand AS, Anderson DG, Vaccaro AR. Trends in epidemiology and management of type II odontoid fractures: 20-year experience at a model system spine injury tertiary referral center. J Spinal Disord Tech. 2010 Dec;23(8):501-5. doi: 10.1097/BSD.0b013e3181cc43c7.
- Smith JS, Kepler CK, Kopjar B, Harrop JS, Arnold P, Chapman JR, Fehlings MG, Vaccaro AR, Shaffrey CI. Effect of type II odontoid fracture nonunion on outcome among elderly patients treated without surgery: based on the AOSpine North America geriatric odontoid fracture study. Spine (Phila Pa 1976). 2013 Dec 15;38(26):2240-6. doi: 10.1097/BRS.0000000000000009.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. december 2005
Primær færdiggørelse (Faktiske)
1. maj 2010
Studieafslutning (Faktiske)
1. maj 2010
Datoer for studieregistrering
Først indsendt
19. december 2005
Først indsendt, der opfyldte QC-kriterier
19. december 2005
Først opslået (Skøn)
20. december 2005
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
11. august 2017
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
9. august 2017
Sidst verificeret
1. august 2017
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 07-GOF-05
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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