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Holdbarhed af Suppl. Stangkonstruktioner - Supplerende stangteknik til langsegmentede posterior instrumenterede spinalfusioner

30. september 2026 opdateret af: AO Foundation, AO Spine

Holdbarhed af supplerende stangkonstruktioner - Supplerende stangteknik (SMART) - til langsegmentede posterior instrumenterede spinalfusionsprocedurer: En multicenter retrospektiv sammenlignende undersøgelse med dobbeltstangskonstruktioner

This is a multicenter retrospective comparative cohort study. The index surgery for this study is primary or revision long-segment posterior thoracolumbar (TL) instrumented fusion using either a supplementary rod construct or a dual-rod construct. Eligible patients who already had index surgery, will be identified for enrollment through a review of medical records of the participating surgeons at the study sites.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

This multicenter retrospective comparative cohort study will enroll 1244 patients, who underwent primary or revision long-segment posterior thoracolumbar (TL) instrumented fusion using either a supplementary rod construct or a dual-rod construct. By comparing two groups of patients, ie, patients treated with supplementary rod constructs vs dual-rod constructs, in the setting of long-segment posterior instrumented spinal fusion, this study aims to provide quality evidence regarding the benefits of supplementary rod constructs in reducing the risk of RFs and other mechanical complications. This study shall provide the first long-term clinical evidence on clinical outcome and benefit of supplementary rod constructs.

All participating surgeons will be asked to identify a time point, denoted as X, when they started using predominantly either supplementary rod constructs or dual-rod constructs for long-segment posterior TL instrumented spinal fusion. This time point X must be on or before December 31, 2020 (the last eligible date for the index surgery). Participating surgeons will be instructed to select the time point X to be as early within the collection window as feasible to maximize the available FU period.

Once the time point X is identified for a participating surgeon, medical records of patients treated by this surgeon will be reviewed to identify consecutive eligible patients with the index surgery done between the time point X and December 31, 2020, inclusive. In the case that an eligible patient had undergone several surgeries during this period, the first primary or revision of long-segment posterior TL instrumented fusion using either a supplementary rod construct or a dual-rod construct is defined as the index surgery.

Patients will then be grouped based on the rod constructs into either the supplementary rod construct group or dual-rod construct group.

The study has two FU periods:

  • The first FU period is the first 2 years after the index surgery. The primary analysis will be done using data from the first 2 years of FU.
  • The second FU period ends on December March 31, 20232024. The duration of this FU therefore ranges from 3 years and 3 months to 10 years and 3 months.

The primary study endpoint is the occurrence of the first RF within 2 years after the index surgery.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

1244

Kontakter og lokationer

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

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Calgary, Canada, T2N 2T9
        • Rekruttering
        • University of Calgary Spine
        • Kontakt:
          • Ganesh Swamy
      • Toronto, Canada, M5T 2S8
        • Rekruttering
        • University of Toronto
        • Kontakt:
          • Stephen Lewis
        • Kontakt:
          • Christopher Nielsen
    • California
      • Redwood City, California, Forenede Stater, 94588
        • Rekruttering
        • Stanford Spine Clinic
        • Kontakt:
      • Sacramento, California, Forenede Stater, 95819
      • San Francisco, California, Forenede Stater, 94144
        • Afsluttet
        • UCSF Spine Center
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • Rekruttering
        • John Hopkis Hospital
        • Kontakt:
          • Khaled Kebaish
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55454
        • Rekruttering
        • University of Minnesota Medical Center
        • Kontakt:
    • Missouri
      • St Louis, Missouri, Forenede Stater, 63110
        • Rekruttering
        • Washington University in St. Louis, School of Medicine
        • Kontakt:
          • Brian Neuman
      • St Louis, Missouri, Forenede Stater, 63310
        • Afsluttet
        • Washington University in St. Louis, School of Medicine, Saint Louis, Missouri 63110
    • New York
      • New York, New York, Forenede Stater, 10032
        • Rekruttering
        • Columbia University / NYP Och Spine Hospital
        • Kontakt:
          • Zeeshan Sardar
    • Virginia
      • Charlottesville, Virginia, Forenede Stater, 22908
      • Hamamatsu, Japan, 431-3192
        • Afsluttet
        • Hamamatsu University School of Medicine
      • Tokyo, Japan, 113-8654
        • Rekruttering
        • University of Tokyo
        • Kontakt:
          • So Kato, Prof
      • Hong Kong, Kina
        • Afsluttet
        • Duchess of Kent Children's Hospital
      • Barcelona, Spanien, 08035
        • Rekruttering
        • Hospital Vall d´Hebron
        • Kontakt:

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

45 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients who underwent long-segment posterior thoracolumbar (TL) instrumented fusion

Beskrivelse

Inclusion Criteria:

  • Age 45 years and older.

  • Patients receiving long-segment posterior TL instrumented fusion using either supplementary rod constructs or dual-rod constructs (the index surgery).

    • Long-segment is defined as the UIV at a thoracic level and the LIV at the sacrum/ilium.
    • Supplementary rod constructs are defined as: in addition to the traditional two primary rods, at least one supplementary rod (eg, accessory rods or satellite rods) is used, and at least one supplementary rod and one primary rod (ie, at least two rods) together must span multiple (≥ 2) vertebral levels. The supplementary rod constructs do not include rods connected end-to-end or side-to-side that do not bridge multiple vertebral levels.
    • The index surgery can be a primary surgery or a revision surgery.
    • The index surgery, staged or non-staged, must use posterior spinal fusion but can be in combination with other approaches such as an anterior procedure.
  • If the index surgery is a revision surgery, the primary rods must be replaced in the revision surgery, with the exception of Harrington or Luque rods which can remain in place.

    o If the Harrington or Luque rods remain in situ, they must already have the UIV at the thoracic level and the LIV at the sacrum/ilium, or an extension of the existing Harrington or Luque is performed such that the UIV is at the thoracic level and the LIV at the sacrum/ilium.

  • The index surgery was performed between January 1, 2014, and December 31, 2020, inclusive.

  • Minimum 3 months of FU after the index surgery.

  • Ability to provide informed consent according to the IRB/EC defined and approved procedures if applicable for retrospective data analysis.

Exclusion Criteria:

  • Spinal fusion performed for acute trauma (ie, ≤ 1 year of trauma).
  • Spinal fusion performed for tumor.
  • Spinal fusion performed for infection.
  • Patients with Parkinson's Disease.
  • Patients with neuromuscular disorders.
  • Patients with spine malignancies requiring chemo- or radiation therapy.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: RETROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
primary/revision long-segment posterior TL instrumented fusion with dual-rod constructs

The index surgery for this study is the primary or revision of long-segment posterior TL instrumented fusion using dual-rod construct.

long-segment posterior TL instrumented fusion with either supplementary rod constructs or dual-rod constructs.

primary/revision long-segment posterior TL instrumented fusion with supplementary rod constructs

The index surgery for this study is the primary or revision of long-segment posterior TL instrumented fusion using either a supplementary rod construct.

long-segment posterior TL instrumented fusion with either supplementary rod constructs or dual-rod constructs.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rod fracture (RF)
Tidsramme: 2 years

Incidence of rod fracture(s)

2 years

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to rod fracture
Tidsramme: 2 years

Time to the first rod fracture after index surgery

2 years
Time to rod fracture
Tidsramme: 10 years and 3 months

Time to the first rod fracture after index surgery

10 years and 3 months
Configurations of supplementary rod constructs
Tidsramme: Baseline

Descriptions of configurations of supplementary rod constructs

Baseline
Treatment for rod fracture
Tidsramme: 10 years and 3 months

Descriptions of different treatment strategies for rod fractures

10 years and 3 months
Recurrent RFs
Tidsramme: 10 years and 3 months

Incidence of recurrent rod fractures

10 years and 3 months
Other mechanical failures
Tidsramme: 10 years and 3 months

Other mechanical failures other than rod fractures

10 years and 3 months
Surgical complications
Tidsramme: 10 years and 3 months

Selective surgical complications

10 years and 3 months

Samarbejdspartnere og efterforskere

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

Efterforskere

  • Ledende efterforsker: Justin S Smith, MD, PhD, Professor of Neurosurgery Chief of Spine Division, Fellowship Director University of Virginia

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)

24. marts 2025

Primær færdiggørelse (Anslået)

15. december 2027

Studieafslutning (Anslået)

31. juli 2029

Datoer for studieregistrering

Først indsendt

20. marts 2024

Først indsendt, der opfyldte QC-kriterier

11. april 2024

Først opslået (Faktiske)

16. april 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • SMART

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

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