腰椎後外側固定術を受けた患者における自家移植片と比較したMagneOs パテの市販後研究 (PROOF)
2レベルの器具を装着した後外側腰椎/胸腰固定術(PLF)を受けている患者を対象に、自家移植片と比較したMagneOsパテの安全性と性能を評価するための前向き無作為化単一施設研究
This is a phase IV post-marketing study for MagnetOs Easypack Putty. MagnetOs Easypack Putty is a synthetic bone graft extender product that is routinely used by surgeons as a treatment for patients with degenerative disc disease or spinal trauma undergoing spinal fusion surgery.
In this study, MagnetOs Easypack Putty will be used according to the latest U.S. Instructions For Use, standalone in the posterolateral spine.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
In this study, following a screening period of a maximum of 30 days, 60 patients will undergo up to two-level instrumented posterolateral fusion (PLF) procedure. Prior to surgery, each patient will be randomized to receive MagnetOs Easypack Putty standalone on the assigned side of the spine and Demineralized Bone Matrix or Fibers mixed with local autograft bone on the other at the diseased levels. They will be followed up at discharge, Week 2, Month 3, Month 6, and Month 12. An interim analysis will be performed once 30 patients have completed their Month 6 visit and have measurements for the endpoints available to measure effectiveness. The primary endpoint will be analyzed at Month 12.
In this study, MagnetOs Easypack Putty will be applied according to the latest Instructions for Use approved in the United States. Specifically, MagnetOs Easypack Putty will be used standalone in patients up to two-level degenerative disc disease with segmental mechanical spinal instability requiring treatment with an instrumented posterolateral spine fusion procedure. The fusion procedure (PLF) will be left to the surgeon's discretion.
Radiographs will be obtained at Screening, Discharge, Month 3, Month 6 and Month 12. CT scans will only be obtained at Month 6 and Month 12.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究場所
-
-
California
-
Irvine、California、アメリカ、92697
- The Regents of the University of California- Irvine Campus
-
-
Michigan
-
Grand Rapids、Michigan、アメリカ、49503
- Corewell Health
-
-
Missouri
-
St Louis、Missouri、アメリカ、63130
- The Washington University
-
-
Pennsylvania
-
Philadelphia、Pennsylvania、アメリカ、19107
- Rothman Orthopaedic Institute
-
-
Tennessee
-
Nashville、Tennessee、アメリカ、37209
- Tennessee Orthopaedic Alliance
-
-
Washington
-
Seattle、Washington、アメリカ、98104
- University of Washington
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patient is able to read/be read, understand, and provide written informed consent and has signed the Institutional Review Board (IRB) approved informed consent.
- Male or female patient ≥ 18 years old.
- Patients with segmental mechanical spinal instability requiring arthrodesis surgery.
Instability can be either caused by degenerative disc disease or by traumatic injury to the spinal column. Patient requiring a maximum of two-level instrumented posterolateral lumbar/thoraco-lumbar fusion (T11 - S1) will be enrolled. Mechanical instability is defined by the presence of one or more of the following:
-
instability (angulation ≥ 5 degrees or translation ≥ 3 mm on flexion/extension radiographs),
-
decreased disc height by > 2 mm, but dependent upon the spinal level
-
Grade II or more listhesis
-
TLICS equal or greater than 5
-
Unstable burst fracture
- Failed conservative treatment (physical therapy, bed rest, medications, spinal injections, manipulations, or transcutaneous electrical nerve stimulation) for a minimum period of 3 months prior to study enrollment (if the patient undergoes elective surgery). Patients who have spinal instability (as defined above in inclusion criteria number three), caused by acute trauma requiring urgent surgical treatment are excluded from this criterion.
Exclusion Criteria:
- Requires > two-level fusion or expected to need secondary intervention within one year following surgery.
- Had prior PLF fusion or attempted PLF fusion at the involved levels.
- Had previous decompression at the involved levels.
- Women who are or intend to become pregnant within the next 12 months.
- To treat conditions in which general bone grafting is not advisable.
- In conditions where the surgical site may be subjected to excessive impact or stresses, including those beyond the load strength of fixation hardware (e.g. defect site stabilization is not possible).
- In case of significant vascular impairment proximal to the graft site.
- In case of severe metabolic or systemic bone disorders (e.g., osteogenesis imperfecta, history of or active Pott's disease, stage >4 renal disease or Paget's Disease) that affect bone or wound healing.
- In case of acute and chronic infections in the operated area (soft tissue infections; inflammation, bacterial bone diseases; osteomyelitis).
- When intraoperative soft tissue coverage is not planned or possible.
- Receiving treatment with medication interfering with calcium metabolism.
- Has degenerative disc disease (DDD) related to a benign or malignant tumor.
- Has history or presence of active malignancy.
- Has known substance abuse, psychiatric disorder, or a condition which, in the opinion of the investigator, may influence the healing or ability to comply with protocol requirements.
- Is involved in active litigation relating to his/her spinal condition.
- Has participated in an investigational study within 30 days prior to surgery for study devices.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:MagnetOs Easypack Putty
Interventions
|
MagnetOs Easypack Putty used standalone in instrumented posterolateral fusion, 5cc-15c per spine level at the randomized assigned side. |
|
アクティブコンパレータ:Demineralized Bone Matrix or Fibers (DBX or Grafton) mixed with local autograft bone
Interventions
|
Demineralized Bone Matrix or Fibers (DBX or Grafton) mixed in a 1:1 vol% with local autologous bone graft used in instrumented posterolateral fusion, 5cc-15cc per level mixed with bone marrow aspirate/blood per spine level at the contralateral side. |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Radiographic Fusion by CT Scan
時間枠:Month 12
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by CT-scan at Month 12. Radiographic as determined by evidence of bridging trabeculae or continuous bony connection between the superior and inferior transverse processes. |
Month 12
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Radiographic Fusion by Plain Radiographs
時間枠:Month 6, Month 12
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by plain radiographs. |
Month 6, Month 12
|
|
Radiographic Fusion by CT Scan
時間枠:Month 6
|
The rate of posterolateral lumbar/thoracolumbar fusion assessed by CT-scan at Month 6. Radiographic as determined by evidence of bridging trabeculae or continuous bony connection between the superior and inferior transverse processes. |
Month 6
|
|
Functional Outcome by Oswestry Disability Index Questionnaire
時間枠:Screening, Week 2, Month 3, 6, and 12
|
Functional outcome by the Oswestry Disability Index questionnaire. Patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. The lower the percentage the higher the patient's functionality. 0-20% minimal disability, 80-100% significant disability or bedridden. |
Screening, Week 2, Month 3, 6, and 12
|
|
Back and Leg Pain by Visual Analog Pain Scale Questionnaire
時間枠:Screening, Week 2, Month 3, 6, and 12
|
Change in back and leg pain using Visual Analog Pain Scale (0-100). Patient-completed questionnaire scoring pain by using 100 mm line. Zero being no pain, 100 is worst pain imaginable. |
Screening, Week 2, Month 3, 6, and 12
|
|
Neurologic Status by Physical Exam
時間枠:Screening, Week 2, Month 3, 6, and 12
|
Change in neurologic status by examination to document stable, improved, or deficits in condition. Stable or improved findings for lower extremities, specifically reflexes, muscle strength, sensory, and straight leg raise. |
Screening, Week 2, Month 3, 6, and 12
|
|
Success Rate
時間枠:Week 2, Month 3, 6, and 12
|
Number of patients with secondary surgical interventions (SSI's) such as revisions, re-operations, removals, supplemental fixations, or any other procedure that adjusts or removes part of the original implant configuration with or without replacement of the components within 12 months of surgery. |
Week 2, Month 3, 6, and 12
|
その他の成果指標
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Safety Endpoint - number of patients with Adverse Events
時間枠:12 Months
|
The number of patients with Adverse Events from Screening up to Month 12 after surgery. |
12 Months
|
|
Safety Endpoint - number of patients with Serious Adverse Events
時間枠:12 Months
|
The number of patients with Serious Adverse Events from Screening up to Month 12 after surgery |
12 Months
|
|
Safety Endpoint - number of patients with Adverse Device Effects
時間枠:12 Months
|
The number of patients with Adverse Device Effects from Screening up to Month 12 after surgery. |
12 Months
|
|
Safety Endpoint - number of patients with Device Related Complications
時間枠:12 Months
|
The number of patients with any complications considered to device related with 12 months after surgery. |
12 Months
|
|
Health Economic - Duration of Surgery
時間枠:12 Months
|
Duration of surgery in minutes. |
12 Months
|
|
Health Economic - Duration of Hospitalization
時間枠:12 Months
|
Duration of hospital stay in days. |
12 Months
|
|
Health Economic - Return to Work
時間枠:12 Months
|
Time to return to work in days. |
12 Months
|
協力者と研究者
協力者
協力者
捜査官
捜査官
- スタディディレクター:Cesar Silva, MD、Kuros BioSciences B.V.
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
その他の研究ID番号
- MAG-920-023
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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