Durabilidad del suministro. Construcciones de varillas: técnica de varillas suplementarias para fusiones espinales instrumentadas de segmentos largos posteriores
Durabilidad de las construcciones de varillas suplementarias (técnica de varillas suplementarias (SMART)) para procedimientos de fusión espinal instrumentada posterior de segmento largo: un estudio comparativo retrospectivo multicéntrico con construcciones de varillas dobles
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.
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
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.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Viola Grünenfelder
- Número de teléfono: +41 79 696 33 97
- Correo electrónico: viola.gruenenfelder@aofoundation.org
Copia de seguridad de contactos de estudio
- Nombre: Alix Frischknecht
- Número de teléfono: +41 79 606 41 48
- Correo electrónico: alix.frischknecht@aofoundation.org
Ubicaciones de estudio
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Calgary, Canadá, T2N 2T9
- Reclutamiento
- University of Calgary Spine
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Contacto:
- Ganesh Swamy
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Toronto, Canadá, M5T 2S8
- Reclutamiento
- University of Toronto
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Contacto:
- Stephen Lewis
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Contacto:
- Christopher Nielsen
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Barcelona, España, 08035
- Reclutamiento
- Hospital Vall d´Hebron
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Contacto:
- Ferran Pellisé, MD
- Correo electrónico: 24361fpu@comb.es
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California
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Redwood City, California, Estados Unidos, 94588
- Reclutamiento
- Stanford Spine Clinic
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Contacto:
- Serena Hu, MD
- Correo electrónico: shu3@stanford.edu
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Sacramento, California, Estados Unidos, 95819
- Reclutamiento
- University of California
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Contacto:
- Yashar Javidan
- Correo electrónico: yjavidan@ucdavis.edu
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San Francisco, California, Estados Unidos, 94144
- Terminado
- UCSF Spine Center
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Maryland
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Baltimore, Maryland, Estados Unidos, 21287
- Reclutamiento
- John Hopkis Hospital
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Contacto:
- Khaled Kebaish
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Minnesota
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Minneapolis, Minnesota, Estados Unidos, 55454
- Reclutamiento
- University of Minnesota Medical Center
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Contacto:
- David Polly, MD
- Correo electrónico: pollydw@umn.edu
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Missouri
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St Louis, Missouri, Estados Unidos, 63110
- Reclutamiento
- Washington University in St. Louis, School of Medicine
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Contacto:
- Brian Neuman
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St Louis, Missouri, Estados Unidos, 63310
- Terminado
- Washington University in St. Louis, School of Medicine, Saint Louis, Missouri 63110
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New York
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New York, New York, Estados Unidos, 10032
- Reclutamiento
- Columbia University / NYP Och Spine Hospital
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Contacto:
- Zeeshan Sardar
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Virginia
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Charlottesville, Virginia, Estados Unidos, 22908
- Reclutamiento
- University of Virginia
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Contacto:
- Justin S Smith, MD, PhD
- Número de teléfono: 434-243-6339
- Correo electrónico: jss7f@virginia.edu
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Contacto:
- Judith G Beenhakker
- Correo electrónico: JGB3P@uvahealth.org
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Kolkata, India
- Reclutamiento
- Kothari Medical Centre
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Contacto:
- Saumayajit Basu, MD
- Correo electrónico: saumyajitbasu@hotmail.com
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Hamamatsu, Japón, 431-3192
- Terminado
- Hamamatsu University School of Medicine
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Tokyo, Japón, 113-8654
- Reclutamiento
- University of Tokyo
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Contacto:
- So Kato, Prof
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Hong Kong, Porcelana
- Terminado
- Duchess of Kent Children's Hospital
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Istanbul, Turquía (Türkiye)
- Reclutamiento
- Acibadem Maslak Hospital
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Contacto:
- Caglar Yilgor, MD
- Correo electrónico: caglaryilgor@gmail.com
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Contacto:
- Ahmet Alanay
- Correo electrónico: aalanay@gmail.com
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Patients who underwent long-segment posterior thoracolumbar (TL) instrumented fusion
Descripción
Inclusion Criteria:
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Age 45 years and older.
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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.
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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.
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The index surgery was performed between January 1, 2014, and December 31, 2020, inclusive.
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Minimum 3 months of FU after the index surgery.
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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.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Modelos observacionales: COHORT
- Perspectivas temporales: RETROSPECTIVE
Número de grupos/cohortes
Cohortes e Intervenciones
Grupo / CohorteGrupo / Cohorte |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
|
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. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Rod fracture (RF)
Periodo de tiempo: 2 years
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Incidence of rod fracture(s) |
2 years
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Time to rod fracture
Periodo de tiempo: 2 years
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Time to the first rod fracture after index surgery |
2 years
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Time to rod fracture
Periodo de tiempo: 10 years and 3 months
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Time to the first rod fracture after index surgery |
10 years and 3 months
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Configurations of supplementary rod constructs
Periodo de tiempo: Baseline
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Descriptions of configurations of supplementary rod constructs |
Baseline
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Treatment for rod fracture
Periodo de tiempo: 10 years and 3 months
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Descriptions of different treatment strategies for rod fractures |
10 years and 3 months
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Recurrent RFs
Periodo de tiempo: 10 years and 3 months
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Incidence of recurrent rod fractures |
10 years and 3 months
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Other mechanical failures
Periodo de tiempo: 10 years and 3 months
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Other mechanical failures other than rod fractures |
10 years and 3 months
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Surgical complications
Periodo de tiempo: 10 years and 3 months
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Selective surgical complications |
10 years and 3 months
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Justin S Smith, MD, PhD, Professor of Neurosurgery Chief of Spine Division, Fellowship Director University of Virginia
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Otros números de identificación del estudio
Otros números de identificación del estudio
- SMART
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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