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Spine FA3 - a Prospective, International, Multicenter Cohort Study on Treatment of of AO A3 Thoracolumbar Fractures (FA3)

Comparison of Surgical Versus Conservative Treatment of AO Type A3 Thoracolumbar Fractures Without Neurological Deficits Prospective, International, Multicenter Cohort Study

Thoracolumbar fractures are the most common spinal fractures with an average annual incidence between 18 and 30 per 100'000 inhabitants. The majority of these fractures are AO type A3 ("burst fractures"). Although patients with burst fractures report a reduced quality of life and chronic pain, there is no clear evidence whether surgical or conservative treatment offer better functional and back-pain related outcomes. The indications for the selection of an ideal treatment for these fractures without neurological deficits remain controversial. The purpose of this study is to evaluate whether patients with thoracolumbar fractures without neurological deficit being surgically treated show faster recovery and better improvement of function than patients being conservatively treated.

Studieoversikt

Studietype

Observasjonsmessig

Registrering (Faktiske)

38

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Curitiba, Brasil
        • Hospital Universitaria Cajuru
      • Porto Alegre, Brasil
        • Hospital Cristo Redentor
      • São Paulo, Brasil
        • Hospital Santa Marcelina
      • Santiago de Chile, Chile
        • Hospital Cristo Redentor
      • Catania, Italia
        • Azienda Ospedaliero - Universitaria Policlinico
      • Almada, Portugal
        • Hospital Garcia e Orta, EPE
      • Liberec, Tsjekkia
        • Krajska Nemocnice Liberec
      • Munich, Tyskland
        • Klinikum rechts der Isar der Technischen Universitat Munchen

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 65 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

140 subjects patients with thoracolumbar fractures will be assigned to ei-ther conservative or surgical treatment depending on the surgeon's decision. Patients will be treated at each institution per standard of care. Surgeons will use their expertise and preferences to determine the method of surgical or conservative intervention.

Beskrivelse

Inclusion Criteria:

  • Age 18-65 years
  • Diagnosis of single or multiple stable thoracolumbar fracture(s)

    • Level T10- L3
    • Type AO A3 or A4
    • Radiologically confirmed by Rx or CT
  • Fracture induced kyphotic deformity lower or equal to 20-35 degrees
  • Definitive treatment (surgical or conservative) within 10 days after injury
  • American Spinal Injury Association (ASIA) Impairment Scale = E (normal )
  • Ability to understand patient information / informed consent form
  • Willingness and ability to participate in the clinical investigation including imaging and follow-up procedures (FUs)
  • Signed informed consent

Exclusion Criteria:

  • Open fracture
  • Polytrauma
  • Pathologic fracture
  • Disruption of the posterior ligamentous complex between T10 and L3
  • Clinically evident osteoporosis as assessed by the investigator
  • Spinal luxation
  • Associated severe lesions as assessed by the investigator
  • Spinal lesion due to gun or projectile
  • Pre-existing spinal column deformity
  • Prior spinal surgeries
  • BMI > 40 kg/m2
  • Any severe medically not managed systemic disease
  • Recent history of substance abuse (ie, recreational drugs, alcohol) that would preclude reli-able assessment
  • Pregnancy or women planning to conceive within the study period
  • Prisoner
  • Participation in any other medical device or medicinal product study within the previous month that could influence the results of the present study

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Surgical treatment

Surgical treatment according to one of the following:

  • Posterior open approach
  • Posterior minimally-invasive surgery (MIS) approach The choice of the approach will be left upon the surgeon's discretion
Andre navn:
  • • Posterior open approach
  • • Posterior minimally-invasive surgery (MIS) approach
Conservative treatment
Conservative treatment according to hospital's standard of care
Andre navn:
  • Conservative treatment according to hospital's standard of care :
  • - Bed rest followed by immobilization with:
  • - Custom-moulded or prefabricated total body contact thoracolumbosacral orthosis (TLSO)
  • - Thermoplastic removable brace, Jewett hyperextension braces, Anterior hyperextension brace (ASH), Taylor-Knight brace
  • - Plaster of Paris (POP)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Roland-Morris Disability Questionnaire (RMDQ)
Tidsramme: 6 week follow up
Improvement in functional outcome from baseline to 6 week follow up (FU) measured with the Roland-Morris Disability Questionnaire (RMDQ)
6 week follow up

Sekundære resultatmål

Resultatmål
Tidsramme
Back pain related disability (Roland-Morris Disability Questionnaire RMDQ)
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Pain (Numeric Rating Scale (NRS))
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months FU
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months FU
Radiologic progress taking into account RX, CT and optionally MRI
Tidsramme: baseline and at follow up after 6 weeks, 3, 6, 12 and 24 months
baseline and at follow up after 6 weeks, 3, 6, 12 and 24 months
Quality of return to work (Denis Work Scale)
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Time to return to work
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Conservative treatment failure rate (eg, change to surgical treatment)
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Rates of local adverse events (AE)
Tidsramme: Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up
Assessed at baseline, 6 weeks, 3, 6, 12 and 24 months follow up

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Giuseppe Barbagallo, MD, Azienda Ospedaliero - Universitaria Policlinico, Catania, Italy
  • Hovedetterforsker: Emiliano Vialle, MD, Catholic University of Parana - Curitiba, Brazil

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2013

Primær fullføring (Faktiske)

1. mars 2015

Studiet fullført (Faktiske)

1. desember 2015

Datoer for studieregistrering

Først innsendt

14. desember 2012

Først innsendt som oppfylte QC-kriteriene

14. desember 2012

Først lagt ut (Anslag)

18. desember 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

13. august 2020

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. august 2020

Sist bekreftet

1. august 2020

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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