이 페이지는 자동 번역되었으며 번역의 정확성을 보장하지 않습니다. 참조하십시오 영문판 원본 텍스트의 경우.

PMCF Study on the Effectiveness and Safety of METROSAN Spinal Systems and BONEGRAFT Filling Materials (INFO SPINE)

2026년 5월 22일 업데이트: Metrosan End. ve Elk. Mek. Cihazlar ve Tibbi Malz. San. Tic. Ltd. Co.

A Prospective, Multi-Center, Observational Post-Market Clinical Follow-Up (PMCF) Study Evaluating the Effectiveness and Safety of METROSAN Spinal Systems and BONEGRAFT Filling Materials Used in Spinal Instrumentation and Fusion Surgery

This is a prospective, multi-center, observational Post-Market Clinical Follow-Up (PMCF) study designed to collect additional safety and clinical performance data on CE-marked Titania® spinal instrumentation and fusion systems, and Bonegraft® bone filling materials (synthetic bone grafts and bone cements). The study aims to evaluate short-term (12-month) safety and effectiveness, identify previously unknown side effects, monitor defined complications, and assess risks based on real-world evidence in patients undergoing spinal surgery. All investigated products are used within their intended purpose under routine clinical practice.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

This prospective, multi-center, observational study evaluates the safety and clinical performance of Titania® spinal instrumentation and fusion systems (manufactured by METROSAN End. ve Elk. Mek. Cihazlar ve Tibbi Malz. San. Tic. Ltd. Sti.) and Bonegraft® bone filling materials, including synthetic bone grafts and bone cements (manufactured by Bonegraft Biyolojik Malzemeler San. ve Tic. A.S.). All investigational products are CE marked and registered in the Turkish Ministry of Health's Product Tracking System (UTS).

The study is purely observational; no additional medical procedures, interventions, or tests beyond routine clinical practice will be performed. Data collection includes retrospective review of preoperative and intraoperative information from patient files, followed by prospective follow-up data collection using a study-specific Electronic Case Report Form (e-CRF). Subjects will be evaluated during routine clinical visits at post-operative Day 12 (±5 days), Week 6, and Months 3, 6, and 12.

Seventeen distinct product groups are evaluated independently, covering cervical interbody fusion cages (Titanium and PEEK), posterior cervical stabilization systems, cervical plate systems, cervical dynamic stabilization systems, cervical disc prostheses (Titanium and PEEK), lumbar interbody fusion cages (Titanium and PEEK), interspinous fusion devices, posterior thoracolumbar stabilization systems, posterior thoracolumbar clamp systems, thoracolumbar dynamic stabilization systems, and bone filling materials (bone cements and synthetic bone grafts).

The enrollment period is planned for 12 months, followed by a 12-month follow-up for each participant. An additional 5 months is allocated for data analysis and reporting, with a total study duration of 29 months. The total estimated enrollment is 561 subjects.

The study is conducted in accordance with the EU Medical Device Regulation (MDR) 2017/745, the Turkish Medical Device Regulation (dated 02.06.2021), ICH-GCP guidelines, the Declaration of Helsinki, and applicable Turkish legislation regarding the protection of personal data.

연구 유형

관찰

등록 (추정된)

561

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

  • 이름: Burak Tülü, Sponsor's Representative
  • 전화번호: +90 (236) 213 10 14
  • 이메일: b.tulu@metrosan.com.tr

연구 장소

  • 터키 (Türkiye)
      • Izmir, 터키 (Türkiye), 35150
        • 모병
        • Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Neurosurgery
        • 연락하다:
          • Hasan Kamil Sucu, Professor
          • 전화번호: +90 (505) 211 8744
          • 이메일: hksucu@gmail.com
        • 수석 연구원:
          • Hasan Kamil Sucu, Professor
        • 부수사관:
          • Ismail Ertan Sevin, Asst. Prof.
      • Izmir, 터키 (Türkiye), 35390
        • 아직 모집하지 않음
        • Demokrasi University Buca Seyfi Demirsoy Training and Research Hospital, Department of Neurosurgery
        • 연락하다:
        • 수석 연구원:
          • Gorkem Yavas, Asst. Prof.
      • Van, 터키 (Türkiye), 65000
        • 아직 모집하지 않음
        • Van Yuzuncu Yil University Dursun Odabas Medical Center, Department of Neurosurgery
        • 연락하다:
        • 수석 연구원:
          • Mehmet Edip Akyol, Assoc. Prof.

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

샘플링 방법

비확률 샘플

연구 인구

Patients aged 18 years or older who underwent cervical or thoracolumbar spinal instrumentation and/or fusion surgery under current medical practice with appropriate indications, in whom at least one of the investigational devices was used, and who meet all inclusion and no exclusion criteria. The study will enroll a total of 561 subjects across 17 product groups (33 subjects per group, accounting for a 10% dropout rate) at 3 centers in Turkey.

All patients who underwent reverse shoulder arthroplasty or hemiarthroplasty using Tıpmed™ Primary Hip Prosthesis Systems, who were informed about this study and voluntarily agreed to participate will be included.

설명

Inclusion Criteria:

  • 18 years of age or older.
  • Skeletally mature.
  • Male or female.
  • Undergone spinal surgery (cervical or thoracolumbar) for any indication under current medical practice.
  • Titania® spinal stabilization/fusion systems and/or BONEGRAFT® bone cements or BONEGRAFT® bone graft materials used during the operation.
  • No general health condition contraindicating surgery.
  • No legal restriction (military service, incarceration, or equivalent).
  • Provision of signed and dated Informed Consent Form (ICF)

Exclusion Criteria:

  • Participation in another interventional clinical investigation
  • Suspected or confirmed pregnancy
  • Morbid obesity
  • Neurological or psychiatric conditions preventing compliance with postoperative care and instructions
  • Active spinal or systemic infection
  • High fever or leukocytosis
  • Severe osteoporosis and/or disease affecting bone metabolism
  • Known allergy or hypersensitivity to PEEK, Titanium, or PMMA
  • Congenital abnormality, tumor, or other condition preventing secure implant fixation or likely to shorten implant useful life
  • Inadequate tissue coverage at the operative site
  • Legally restricted individuals (military personnel, prisoners, etc.)

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

코호트 및 개입

그룹/코호트
개입 / 치료
Cervical Interbody Fusion Cages (Titanium)
Subjects undergoing surgery with "Titania® Cervical Interbody Fusion Cages (Titanium)" will be followed for 12 months.
장치: Titania® Cervical Interbody Fusion Cage (Titanium)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Cervical Interbody Fusion Cages (PEEK)
Subjects undergoing surgery with "Titania® Cervical Interbody Fusion Cages (PEEK)" will be followed for 12 months.
장치: Titania® Cervical Interbody Fusion Cage (PEEK)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Posterior Cervical Stabilization Systems
Subjects undergoing surgery with "Titania® Posterior Cervical Stabilization Systems" will be followed for 12 months.
장치: Titania® Posterior Cervical Stabilization System
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Cervical Plate Systems
Subjects undergoing surgery with "Titania® Cervical Plate System" will be followed for 12 months.
장치: Titania® Cervical Plate System
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Cervical Dynamic Stabilization Systems (Elastic Rod)
Subjects undergoing surgery with "Titania® Cervical Dynamic Stabilization Systems (Elastic Rod)" will be followed for 12 months.
장치: Titania® Cervical Dynamic Stabilization System (Elastic Rod)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Cervical Disc Prosthesis (Titanium)
Subjects undergoing surgery with "Titania® Cervical Disc Prosthesis (Titanium)" will be followed for 12 months.
장치: Titania® Cervical Disc Prosthesis (Titanium)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Cervical Disc Prosthesis (PEEK)
Subjects undergoing surgery with "Titania® Cervical Disc Prosthesis (PEEK)" will be followed for 12 months.
장치: Titania® Cervical Disc Prosthesis (PEEK)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Lumbar Interbody Fusion Cages (Titanium)
Subjects undergoing surgery with "Titania® Lumbar Interbody Fusion Cages (Titanium)" will be followed for 12 months.
장치: Titania® Lumbar Interbody Fusion Cages (Titanium)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Lumbar Interbody Fusion Cages (PEEK)
Subjects undergoing surgery with "Titania® Lumbar Interbody Fusion Cages (PEEK)" will be followed for 12 months.
장치: Titania® Lumbar Interbody Fusion Cages (PEEK)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Interspinous Fusion Device (Titanium)
Subjects undergoing surgery with "Titania® Interspinous Fusion Device (Titanium)" will be followed for 12 months.
장치: Titania® Interspinous Fusion Device (Titanium)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Posterior Thoracolumbar Stabilization Systems
Subjects undergoing surgery with "Titania® Posterior Thoracolumbar Stabilization Systems" will be followed for 12 months.
장치: Titania® Posterior Thoracolumbar Stabilization Systems
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Posterior Thoracolumbar Clamp Systems
Subjects undergoing surgery with "Titania® Posterior Thoracolumbar Clamp Systems" will be followed for 12 months.
장치: Titania® Posterior Thoracolumbar Clamp Systems
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Thoracolumbar Dynamic Stabilization Systems (Elastic Rod)
Subjects undergoing surgery with "Titania® Thoracolumbar Dynamic Stabilization Systems (Elastic Rod)" will be followed for 12 months.
장치: Titania® Thoracolumbar Dynamic Stabilization System (Elastic Rod)
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Synthetic Bone Grafts (Cervical Application)
Subjects undergoing surgery with "Bonegraft® Synthetic Bone Grafts" will be followed for 12 months. The product is evaluated within this group specifically for its application and clinical outcomes (e.g., NDI scores) in the cervical region.
장치: Bonegraft® Synthetic Bone Grafts
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Synthetic Bone Grafts (Thoracolumbar Application)
Subjects undergoing surgery with "Bonegraft® Synthetic Bone Grafts" will be followed for 12 months. The product is evaluated within this group specifically for its application and clinical outcomes (e.g., ODI scores) in the thoracolumbar region.
장치: Bonegraft® Synthetic Bone Grafts
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Bone Cement (Cervical Application)
Subjects undergoing surgery with "Bonegraft® Synthetic Bone Cement" will be followed for 12 months. The product is evaluated within this group specifically for its application and clinical outcomes (e.g., ODI scores) in the cervical region.
장치: Bonegraft® Bone Cement
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.
Bone Cement (Thoracolumbar Application)
Subjects undergoing surgery with "Bonegraft® Synthetic Bone Cement" will be followed for 12 months. The product is evaluated within this group specifically for its application and clinical outcomes (e.g., ODI scores) in the thoracolumbar region.
장치: Bonegraft® Bone Cement
This is a post-market clinical follow-up (PMCF) of the CE-marked device used according to its intended purpose within routine clinical practice. As this is an observational study, the device is selected and applied based on the physician's clinical judgment, and no additional interventions or procedures beyond standard care are performed.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in Neck Disability Index (NDI) score from baseline (for Cervical Spinal Instrumentation and Fusion Systems)
기간: [12 months]
The NDI is used to evaluate neck-pain-related disability. It consists of 10 items, each scored from 0 to 5. While the total raw score ranges from 0 to 50, results are expressed as a percentage (0-100%) for clinical evaluation, consistent with the referenced literature (Heller et al., 2009). Following clinical benchmarks, a reduction of ≥15% in the NDI score at the 12th-month follow-up compared to baseline is defined as a successful clinical improvement.
[12 months]
Change in Oswestry Disability Index (ODI) score from baseline (for Thoracolumbar Spinal Instrumentation and Fusion Systems)
기간: [12 months]

The ODI is used to assess the impact of thoracolumbar pain on daily life activities (personal care, lifting, walking, sitting, standing, sleeping, sexual life, social life, and travel). It consists of 10 items, each scored from 0 to 5. The total score is calculated using the formula: (total score x 100) / (5 x number of questions answered), resulting in a scale from 0 (best) to 100 (worst). Evaluations will be performed at baseline (pre-op) and at each follow-up visit (Day 12, Week 6, and Months 3, 6, and 12).

A reduction of ≥15 points in the ODI score at the 12th-month follow-up compared to baseline is defined as a successful clinical improvement.
[12 months]
Fusion rate for Spinal Fusion Systems
기간: [12 months]

Fusion status will be evaluated using radiographs and/or CT scans (if available) at each postoperative follow-up visit. The assessment is based on the presence of a continuous trabecular bone bridge between the vertebral bodies. Fusion will be categorized into three groups:

Solid Fusion: Presence of a continuous bone bridge between the vertebrae.

Fibrous Fusion: Absence of a continuous bone bridge, but no signs of instability (translation < 3 mm on dynamic radiographs).

Non-fusion: Absence of a continuous bone bridge along with abnormal motion (> 3 mm translation on radiographs).

The evaluation will be concluded once solid fusion is achieved.
[12 months]
Adjacent segment motion in subjects with dynamic instrumentation
기간: [12 months]
In subjects undergoing dynamic posterior stabilization, motion at the adjacent segments will be evaluated using flexion and extension radiographs (if available) at all follow-up visits. The primary assessment involves measuring the differences in the disc space angles. These measurements will be compared with baseline (preoperative) values to monitor changes in adjacent segment mobility over the 12-month follow-up period.
[12 months]
Change in Intervertebral Disc Height
기간: [12 months]
The intervertebral disc height will be evaluated at each follow-up visit using the Dabbs method. The assessment is based on the average of the measurements taken from the anterior and posterior regions of the disc space, expressed in millimeters (mm) by the formula (A+B)/2. These radiological measurements will be compared with preoperative (baseline) values to identify any changes in disc height throughout the 12-month follow-up period.
[12 months]
Assessment of Intervertebral Disc Degeneration
기간: 12 months
Intervertebral disc degeneration will be evaluated at each follow-up visit using the Pfirrmann Classification system. This system grades the degree of disc degeneration based on MRI (Magnetic Resonance Imaging) findings, focusing on disc structure, distinction between nucleus and annulus, signal intensity, and disc height. The scale ranges from Grade I (normal disc structure with high signal intensity) to Grade V (severe degeneration with collapsed disc space). Categorical grades obtained at each control period will be compared with baseline (preoperative) status to monitor the progression or stabilization of disc degeneration throughout the 12-month follow-up period, where a shift toward higher grades signifies worsening of degeneration.
12 months
Cervical and segmental lordosis assessment (for Cervical Spinal Instrumentation and Fusion Systems)
기간: [12 months]
Cervical and segmental lordosis will be evaluated at each follow-up visit and compared with preoperative measurements. Lateral radiographs of the cervical spine will be used to measure lordosis angles using the Cobb angle method. This assessment aims to monitor the maintenance or restoration of the sagittal alignment of the cervical spine and the specific treated segments throughout the 12-month follow-up period.
[12 months]
Lordosis restoration and sagittal balance assessment (for Thoracolumbar Spinal Instrumentation and Fusion Systems)
기간: [12 months]
Sagittal balance and lordosis restoration will be evaluated using full-spine radiographs (tele-radiographies, if available) at baseline and each follow-up visit (Day 12, Week 6, Months 3, 6, and 12). Clinical success will be assessed based on the Schwab sagittal alignment classification parameters. This assessment is a categorical evaluation based on whether patients achieve the predefined optimal correction thresholds for three key spinal parameters: 1) Sagittal Vertical Axis (SVA) < 50 millimeters, 2) Pelvic Tilt (PT) < 20 degrees, and 3) Pelvic Incidence minus Lumbar Lordosis (PI-LL) mismatch within ±9 degrees. At each follow-up period, patients will be categorized into two groups: those who achieve all these optimal parameters and those who do not. Patients meeting all three thresholds will be classified as 'successful' according to the Schwab criteria.
[12 months]
Incidence of adverse events and complications
기간: [12 months]
Safety data will be collected by recording all adverse events (AEs) and complications encountered during the 12-month follow-up period. This includes intraoperative complications, device-related failures, and any postoperative adverse events (e.g., infection, neurological deficit, or reoperation).
[12 months]

2차 결과 측정

결과 측정
측정값 설명
기간
Clinical outcome assessment using Odom's Criteria
기간: [12 months]
Patient clinical outcomes will be evaluated at each follow-up visit using Odom's Criteria, which classifies results as 'Excellent', 'Good', 'Fair', or 'Poor' based on symptom relief and the ability to perform daily activities. Clinical success is defined as the proportion of subjects achieving 'Excellent' or 'Good' scores, representing significant improvement compared to baseline.
[12 months]
Assessment of pain using Visual Analog Scale (VAS)
기간: [12 months]
Pain intensity and changes in pain levels will be evaluated at each follow-up visit using the Visual Analog Scale (VAS) and compared with baseline measurements. Patients mark their pain level on a 100 mm (or 10 cm) line, where 0 represents no pain and 100 represents the worst pain. A decrease of ≥20 mm (or 2 cm) in pain intensity at the 12th-month follow-up compared to baseline is considered a successful clinical outcome.
[12 months]
Assessment of health-related quality of life with SF-12
기간: [12 months]
Health-related quality of life and changes in quality of life perception will be evaluated at each follow-up visit using the SF-12 Health Survey and compared with baseline measurements. Each domain of the survey is evaluated independently. Scores for each domain range from 0 to 100, where 0 represents the worst possible health state and 100 represents the best possible health state.
[12 months]
Patient satisfaction assessment
기간: [12 months]
Patient satisfaction will be evaluated at the final follow-up visit (12 months) using a 3-point Likert scale based on three specific questions directed to the subject. The scale consists of three response options: 'Yes', 'Undecided', and 'No'. The proportion of patients responding 'Yes' to the satisfaction questions will be analyzed to determine the overall treatment satisfaction rate.
[12 months]

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

Metrosan End. ve Elk. Mek. Cihazlar ve Tibbi Malz. San. Tic. Ltd. Co.

협력자

Bonegraft Biyolojik Malzemeler San. ve Tic. A.S.

수사관

  • 연구 책임자: Hasan Kamil Sucu, Professor, Izmir Katip Celebi University Ataturk Training and Research Hospital

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2026년 4월 27일

기본 완료 (추정된)

2028년 4월 26일

연구 완료 (추정된)

2028년 9월 26일

연구 등록 날짜

최초 제출

2026년 5월 18일

QC 기준을 충족하는 최초 제출

2026년 5월 22일

처음 게시됨 (실제)

2026년 5월 29일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 5월 29일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 5월 22일

마지막으로 확인됨

2026년 5월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • INFO SPINE
  • 2025-223 (기타 식별자: Turkish Medicines and Medical Devices Agency (TITCK))

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

IPD 계획 설명

Data will not be shared due to confidentiality and intellectual property policies of the sponsor.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

척추관 협착증에 대한 임상 시험

Titania® Cervical Interbody Fusion Cage (Titanium)에 대한 임상 시험

유사한 임상시험 검색

스폰서 및 공동 작업자

건강 상태

약물 개입

CROs by country

CROs in Slovakia

정황

희귀 질병

약물 개입

식이 보충제

스폰서 / 협력자

위치

구독하다