Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Trinity Evolution in Anterior Cervical Disectomy and Fusion (ACDF)

7. april 2014 opdateret af: Orthofix Inc.

A Radiographic and Clinical Study Evaluating a Novel Allogeneic, Cancellous, Bone Matrix Containing Viable Stem Cells (Trinity Evolution™ Viable Cryopreserved Cellular Bone Matrix) in Patients Undergoing Anterior Cervical Discectomy and Fusion

The purpose of this study is to utilize Trinity Evolution in conjunction with an interbody spacer and supplemental anterior fixation of the surgeon's choice and to follow the patients to measure the clinical outcomes and rate of fusion. The hypothesis of the study is that Trinity Evolution combined with an interbody spacer and supplemental anterior fixation will result in fusion rates and clinical outcomes similar to those with other routinely used autograft and allograft materials including: fusion, improvement in pain and function, maintenance of upper extremity neurological function, and absence of serious adverse events related to the use of the Trinity Evolution product.

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

When conservative care fails to alleviate the pain and neurological deficits caused by degenerative disc disease in a cervical spine, the most common recourse is surgical decompression of the affected nerves and/or spinal cord. Decompression is often accomplished via an anterior approach whereby essentially the entire disc as well as any bony osteophytes and ligaments that are compressing the spinal cord and/or nerves are removed. While usually successful at decompressing affected neural structures, the decompression often results in collapse of the disc space, instability and recurrent symptomatology.

Most anterior cervical decompressions therefore are followed by insertion of a structural interbody spacer such as a bone graft from the patient's iliac crest (autograft) or a bone graft from a cadaver (allograft). The "gold standard" for aiding healing in spinal fusion surgeries is the harvesting of autograft from the patient's iliac crest and placing it in and around the segments of the spine that are intended to be fused. Autograft is considered the "gold standard" because it contains the essential elements required for successful bone grafting: osteogenesis, osteoconduction, and osteoinduction.

However, the morbidity of harvesting autograft has been well documented and includes chronic donor-site pain, infection, neurologic injury, blood loss, deformity, bowel injury, hernia, and prolonged surgical and hospitalization time. There are now a number of products on the market to minimize or replace the use of autograft. However, few of these products contain all three essential bone-forming elements (osteogenesis, osteoconduction, and osteoinduction) in a single, stand alone product.

Trinity Evolution is a novel, allogeneic cancellous bone matrix containing viable osteoprogenitor cells, mesenchymal stem cells and demineralized cortical bone (DCB) component to provide the required osteoconduction, osteogenesis, and osteoinduction necessary for successful bone grafting. Preclinical studies with Trinity Evolution have demonstrated in-vitro and in-vivo safety and effectiveness. Trinity Evolution is considered an allograft and as such is a "minimally manipulated" tissue and is labeled for bone repair for spinal, orthopedic and podiatric indications where autograft is used. The dosage will be dependent upon the specific requirements of the case.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

200

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • California
      • Encinitas, California, Forenede Stater, 92024
        • CORE Orthopaedic Medical Center
      • Redding, California, Forenede Stater, 96001
        • Shasta Orthopaedics Spine Center
    • Colorado
      • Parker, Colorado, Forenede Stater, 80134
        • Denver-Vail Orthopedics, P.C.
    • Connecticut
      • New Britain, Connecticut, Forenede Stater, 28204
        • Central Connecticut Neurosurgery and Spine
    • Kansas
      • Kansas City, Kansas, Forenede Stater, 66160
        • Kansas University Medical Center
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48109-5338
        • University of Michigan, A. Alfred Taubman Health Care Center
    • Nevada
      • Las Vegas, Nevada, Forenede Stater, 89109
        • Western Regional Center for Spine and Brain Surgery
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28204
        • Carolina NeuroSurgery & Spine
      • Raleigh, North Carolina, Forenede Stater, 27607
        • Triangle Neurosurgery
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater, 19107
        • Jefferson Medical College
    • Texas
      • The Woodlands, Texas, Forenede Stater, 77381
        • Greater Houston Neurosurgery Center
    • Virginia
      • Reston, Virginia, Forenede Stater, 20190
        • The Virginia Spine Institute
      • Richmond, Virginia, Forenede Stater, 23226
        • Tuckahoe Orthopaedic Associates

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

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Subject selection will be conducted by patient's neurosurgeon or orthopedic surgeon.

Beskrivelse

Inclusion Criteria:

  • Symptomatic cervical degenerative disc disease at up to four levels between C3 and T1
  • Neck and/or arm pain and/or a functional neurological deficit, and/or cervical myelopathy with neural compression confirmed by plain x-rays and MRI, Myelogram or CT. Scheduled for an ACDF with a spacer and anterior supplemental fixation of the surgeon's choice.
  • Greater than 18 years of age
  • Unresponsive to conservative care over a period of at least 6 weeks or has progressive neurological signs and/or symptoms of neurological compromise that mandate urgent surgical intervention.
  • Willing and able to comply with the requirements of the protocol including follow-up requirements
  • Willing and able to sign a study specific informed consent.

Exclusion Criteria:

  • More than 4 levels (C3 - T1) requiring surgical treatment
  • Active local or systemic infection
  • Currently pregnant or considering becoming pregnant during the follow-up period
  • Active malignancy or having been on chemotherapy of any kind for a malignancy in the past 1 year.
  • Axial neck pain as the primary diagnosis, without evidence of neural compression
  • Use of any other bone graft or bone graft substitute in addition to or in place of Trinity Evolution in and around the interbody spacer
  • Use of adjunctive post-operative stimulation
  • Prior interbody surgery at the same level
  • Has a known history of hypersensitivity or anaphylactic reaction to dimethyl sulfoxide (DMSO).

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Fusion Rates for Trinity Evolution
Tidsramme: Operative to 12 months Follow-up
Operative to 12 months Follow-up

Sekundære resultatmål

Resultatmål
Tidsramme
NDI relative improvement, VAS improvement, Maintenance or improvement of neurological function
Tidsramme: Pre-operative to 12 months follow-up
Pre-operative to 12 months follow-up
Complication Rates for Trinity Evolution
Tidsramme: Operative to 12 months follow-up
Operative to 12 months follow-up

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Orthofix Inc.

Efterforskere

  • Studieleder: Raymond J Linovitz, MD, Orthofix Spinal Implants

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

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. august 2009

Primær færdiggørelse (Faktiske)

1. august 2012

Studieafslutning (Faktiske)

1. august 2012

Datoer for studieregistrering

Først indsendt

31. juli 2009

Først indsendt, der opfyldte QC-kriterier

3. august 2009

Først opslået (Skøn)

4. august 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

8. april 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. april 2014

Sidst verificeret

1. april 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CP-01005A

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 .

Abonner