ADDRESS - Adult Deformity Robotic vs. Freehand Surgery to Correct Spinal Deformity
30. september 2020 opdateret af: Mazor Robotics
ADDRESS - Multicenter, Partially-randomized Controlled Trial of Adult Deformity Robotic vs. Freehand Surgery to Correct Adult Spine Deformity
To quantify potential short- and long-term benefits of robotically-guided minimally invasive (MIS) or open-approach spine surgery in adult patients undergoing multi-level spinal instrumentation surgery, in comparison to image- or navigation-guided instrumentation in a matching cohort of control patients, performed using a freehand technique, both in MIS and open approaches.
Studieoversigt
Status
Trukket tilbage
Betingelser
Undersøgelsestype
Observationel
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Kansas
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Kansas City, Kansas, Forenede Stater, 66160
- University of Kansas Medical Center
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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
21 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
Adult patients (age over 21 years) undergoing long (5 or more consecutive vertebrae) open or minimally invasive instrumentation, correction and fusion sugery in the thoracic, lumbar or sacral spine who have been found to have kypho/scoliotic curve, sagittal or coronal imbalance or a combination of these.
Beskrivelse
Inclusion Criteria:
- Adult patients (age 21 years and older), undergoing long (5 consecutive vertebrae or more) spinal fusion surgery, between T1 to the sacrum.
- Cases may include surgeries involving iliac screws (e.g., Galveston technique or S2AI screws) although these screws will not be included in the data analysis.
- Cases may include augmented cases (when one or more of the screws are inserted into vertebrae after a vertebral augmentation procedure, such as kyphoplasty or vertebroplasty).
- Patient capable of complying with study requirements
- Signed informed consent by patient
Exclusion Criteria:
- Infection or malignancy
- Primary abnormalities of bones (e.g. osteogenesis imperfecta)
- Primary muscle diseases, such as muscular dystrophy
- Neurologic diseases (e.g. Charcot-Marie Tooth, Guillain-Barre syndrome, cerebral palsy, spina bifida, or neurofibroma)
- Spinal cord abnormalities with any neurologic symptoms or signs
- Spinal cord lesions requiring neurosurgical interventions, such as hydromyelia
- Paraplegia
- Patients who have participated in a research study involving an investigational product in the 12 weeks prior to surgery
- Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the study, or may influence the result of the study.
- Pregnancy
- Patient cannot follow study protocol, for any reason
- Patient cannot or will not sign informed consent
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 |
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Arm 1: Robotic-guided, Open approach
Adult patients (age> 21 years) undergoing long (>4 consecutive vertebrae) open instrumentation, correction and fusion surgery in the thoracic, lumbar or sacral spine for a kypho/scoliotic curve, sagittal or coronal imbalance or a combination of these.
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Arm 2: control-arm - non-robotic, open approach
Adult patients (age> 21 years) undergoing long (>4 consecutive vertebrae) open instrumentation, correction and fusion surgery in the thoracic, lumbar or sacral spine for a kypho/scoliotic curve, sagittal or coronal imbalance or a combination of these.
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Arm 3: robotic-guided, MIS approach
Adult patients (age> 21 years) undergoing long (>4 consecutive vertebrae) open instrumentation, correction and fusion surgery in the thoracic, lumbar or sacral spine for a kypho/scoliotic curve, sagittal or coronal imbalance or a combination of these.
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Arm 4: control-arm - freehand, MIS approach
Adult patients (age> 21 years) undergoing long (>4 consecutive vertebrae) open instrumentation, correction and fusion surgery in the thoracic, lumbar or sacral spine for a kypho/scoliotic curve, sagittal or coronal imbalance or a combination of these.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Incidence of surgical complications
Tidsramme: 1 year
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New neural deficits, implant-related durotomy, infection requiring surgery, excessive blood loss
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1 year
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Intraoperative radiation exposure
Tidsramme: Day of operation
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as measured by the C-arm, normalized per screw
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Day of operation
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Revision surgeries
Tidsramme: 2 years
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All cause revisions, including medical and surgical complications.
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2 years
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Deformity correction as measured on plain radiographs
Tidsramme: Within 2 years from surgery
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Parameters of sagittal and coronal balance
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Within 2 years from surgery
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Clinical outcome measures assessed using health-related quality of life questionnaires
Tidsramme: up to 10 years post-operative
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Visual Analog Scale (VAS) back and leg, Oswestry Disability Index (ODI), SRS22 questionnaire, European Quality - 5 dimensions (EQ-5D-5L)
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up to 10 years post-operative
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Pedicle screw instrumentation accuracy
Tidsramme: Within 1 year of surgery
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Accuracy will be quantified in millimeters and scored using the Gertzbein Robbins classification, based on post-operative CTs that are clinically necessary for the management of the patient.
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Within 1 year of surgery
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Length of convalescence
Tidsramme: Within 2 years of surgery
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Length of stay at the hospital, destination at discharge, time to return to normal activities, time to return to work
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Within 2 years of surgery
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Ratio of executed vs. planned screws
Tidsramme: Day of surgery
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Number of screws planned to be robotically inserted but manually inserted instead, and cause.
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Day of surgery
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Times of intra-operative stages
Tidsramme: Day of surgery
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Instrumentation time per screw, total surgery time
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Day of surgery
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Implant Failure
Tidsramme: Within 1 year post-surgery
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The implant failure rate as measured within one year post-surgery
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Within 1 year post-surgery
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Number of Abandoned Screws
Tidsramme: Day of surgery
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Number of screws intended to be instrumented with the robot and abandoned for cause.
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Day of surgery
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Number of screws instrumented freehand
Tidsramme: Day of surgery
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Number of screws planned to be instrumented robotically and instrumented freehand instead.
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Day of surgery
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Clinical performance of instrumentation technique
Tidsramme: Day of surgery
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Implant instrumentation time, length of surgery
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Day of surgery
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Fusion rate/pseudoarthrosis
Tidsramme: Within one year post-surgery
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Fusion/pseudoarthrosis as measured within one year of surgery
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Within one year post-surgery
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Neuromonitoring events
Tidsramme: Day of surgery
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The number of clinically significant neuromonitoring events that may or may not lead to removal or reinstrumentation of the pedicle screw.
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Day of surgery
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Efterforskere
- Studieleder: Doron Dinstein, MD, Mazor Robotics
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
- Devito DP, Kaplan L, Dietl R, Pfeiffer M, Horne D, Silberstein B, Hardenbrook M, Kiriyanthan G, Barzilay Y, Bruskin A, Sackerer D, Alexandrovsky V, Stuer C, Burger R, Maeurer J, Donald GD, Schoenmayr R, Friedlander A, Knoller N, Schmieder K, Pechlivanis I, Kim IS, Meyer B, Shoham M. Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study. Spine (Phila Pa 1976). 2010 Nov 15;35(24):2109-15. doi: 10.1097/BRS.0b013e3181d323ab. Erratum In: Spine (Phila Pa 1976). 2011 Jan 1;36(1):91. Gordon, Donald G [corrected to Donald, Gordon D].
- Hu X, Ohnmeiss DD, Lieberman IH. Use of an ultrasonic osteotome device in spine surgery: experience from the first 128 patients. Eur Spine J. 2013 Dec;22(12):2845-9. doi: 10.1007/s00586-013-2780-y. Epub 2013 Apr 16.
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 (Faktiske)
3. oktober 2014
Primær færdiggørelse (Faktiske)
1. marts 2015
Studieafslutning (Faktiske)
1. marts 2015
Datoer for studieregistrering
Først indsendt
6. februar 2014
Først indsendt, der opfyldte QC-kriterier
7. februar 2014
Først opslået (Skøn)
10. februar 2014
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
5. oktober 2020
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
30. september 2020
Sidst verificeret
1. september 2020
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- CLN105
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 .