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

2020年8月11日 更新者：AO Clinical Investigation and Publishing Documentation

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.

研究概览

地位

终止

条件

干预/治疗

研究类型

观察性的

注册 (实际的)

38

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

  • 巴西
      • Curitiba、巴西
        • Hospital Universitaria Cajuru
      • Porto Alegre、巴西
        • Hospital Cristo Redentor
      • São Paulo、巴西
        • Hospital Santa Marcelina
  • 德国
      • Munich、德国
        • Klinikum rechts der Isar der Technischen Universität München
  • 意大利
      • Catania、意大利
        • Azienda Ospedaliero - Universitaria Policlinico
  • 捷克语
      • Liberec、捷克语
        • Krajská nemocnice Liberec
  • 智利
      • Santiago de Chile、智利
        • Hospital Cristo Redentor
  • 葡萄牙
      • Almada、葡萄牙
        • Hospital Garcia e Orta, EPE

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 65年 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

非概率样本

研究人群

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.

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

队列和干预

团体/队列
干预/治疗
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
程序：Surgical
其他名称：
  • • Posterior open approach
  • • Posterior minimally-invasive surgery (MIS) approach
Conservative treatment
Conservative treatment according to hospital's standard of care
程序：Conservative treatment
其他名称：
  • 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)

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Roland-Morris Disability Questionnaire (RMDQ)
大体时间：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

次要结果测量

结果测量
大体时间
Back pain related disability (Roland-Morris Disability Questionnaire RMDQ)
大体时间：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))
大体时间：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
大体时间：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)
大体时间：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
大体时间：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)
大体时间：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)
大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

AO Clinical Investigation and Publishing Documentation

调查人员

  • 首席研究员：Giuseppe Barbagallo, MD、Azienda Ospedaliero - Universitaria Policlinico, Catania, Italy
  • 首席研究员：Emiliano Vialle, MD、Catholic University of Parana - Curitiba, Brazil

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2013年1月1日

初级完成 (实际的)

2015年3月1日

研究完成 (实际的)

2015年12月1日

研究注册日期

首次提交

2012年12月14日

首先提交符合 QC 标准的

2012年12月14日

首次发布 (估计)

2012年12月18日

研究记录更新

最后更新发布 (实际的)

2020年8月13日

上次提交的符合 QC 标准的更新

2020年8月11日

最后验证

2020年8月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • Spine FA3

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