Advent™ Cervical Disc Versus Anterior Cervical Discectomy and Fusion(ACDF) for Treatment of One Level Degenerative Disc Disease (IDE Study)
This study has suspended participant recruitment.
(Greater-than-anticipated rate of revisions)
Sponsor:
Orthofix Inc.
Information provided by (Responsible Party):
Orthofix Inc.
ClinicalTrials.gov Identifier:
NCT00637312
First received: March 10, 2008
Last updated: October 10, 2012
Last verified: October 2012
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Purpose
The purpose of this study is to establish the safety and effectiveness of the Advent™ Cervical Disc compared to Anterior Cervical Discectomy and Fusion (ACDF) in treating degenerative disc disease at a single-level in the cervical spine (from C3 to C7) following cervical discectomy in skeletally mature patients (at least 18 years of age).
| Condition | Intervention |
|---|---|
|
Cervical Degenerative Disc Disease |
Device: Cervical Artificial Disc (Advent™ Cervical Disc) Device: ACDF (Hallmark™ Anterior Cervical Plate System with corticocancellous allograft bone) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Clinical Trial Comparing the Blackstone Advent™ Cervical Disc to Anterior Cervical Discectomy and Fusion (ACDF) for the Treatment of One Level Degenerative Disc Disease |
Further study details as provided by Orthofix Inc.:
Primary Outcome Measures:
- Evaluation of device and/or procedure related adverse event(s) [ Time Frame: At 24-months ] [ Designated as safety issue: Yes ]
- Maintenance or improvement neurological status [ Time Frame: At 24-months ] [ Designated as safety issue: Yes ]
- Improvement in Neck Disability Index [ Time Frame: At 24 months ] [ Designated as safety issue: No ]
- Quantitative radiographic assessment of range of motion (ROM) and qualitative radiographic fusion assessment [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Arm and neck pain as measured by Visual Analogue Scales (VAS) [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Odom's criteria score [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Nurick's Classification [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Overall Quality of Life (SF-36v2™) [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Disc height maintenance [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Pain medication use [ Time Frame: At 24-months ] [ Designated as safety issue: No ]
- Post-operative time to normal activity [ Time Frame: At 24 months ] [ Designated as safety issue: No ]
- Self-reported satisfaction with treatment [ Time Frame: At 24 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 450 |
| Study Start Date: | March 2008 |
| Estimated Study Completion Date: | February 2013 |
| Primary Completion Date: | July 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Advent™ Cervical Disc
|
Device: Cervical Artificial Disc (Advent™ Cervical Disc)
Advent™ Cervical Disc
Other Name: Advent™ Cervical Disc
|
|
Active Comparator: 2
ACDF Control
|
Device: ACDF (Hallmark™ Anterior Cervical Plate System with corticocancellous allograft bone)
Hallmark™ Anterior Cervical Plate System with corticocancellous allograft bone
Other Names:
|
Detailed Description:
Following surgery study subjects will be evaluated at the following intervals: 6 wks (± 2wks); 3 Months (±2 wks); 6 Month (±1 months); 12 and 24 Month (±2 months) and annually until the last subject enrolled completes their 24 Month follow-up
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- One cervical spine level between C3 and C7 which requires surgical treatment for intractable cervical radiculopathy and/or myelopathy demonstrated by herniated disc, and/or osteophyte formation leading to nerve root and/or spinal cord compression confirmed by patient history (e.g. neck and/or arm pain), functional and/or neurological deficit (e.g. numbness, weakness, diminished or pathologic reflexes, gait disturbances, etc.) and radiographic studies (e.g. CT, MRI, x-rays, etc.).
- Unresponsive to conservative care over a period of at least 6 weeks
- Neck Disability Index score ≥ 15/50 (30%)
- Willing and able to comply with the requirements of the protocol including follow-up requirements and to sign a study specific informed consent
Exclusion Criteria:
- More than 1 level requiring surgical treatment for intractable cervical radiculopathy and/or myelopathy.
- Active local (at the proposed surgical site) or systemic infection
- Prior anterior neck surgery at any level.
- Prior posterior cervical spine surgery at the index level except posterior decompressive surgery where the posterior elements are preserved.
- Currently undergoing treatment for disease of the thoracic or lumbar spine.
- Axial neck pain as the primary diagnosis, without evidence of neural compression
- Significant cervical anatomical deformity
- Any anatomical consideration which in the investigators opinion would make the anterior cervical approach excessively risky or impossible
- Severe obesity defined as a Body Mass Index (BMI) > 40
- Instability on AP, lateral neutral or flex/ext images: ≥2mm translation relative to the adjacent segment, and/or ≥ 11 degrees relative to adjacent segments
- Central disc height ≤ 2mm
- Advanced spondylosis (i.e. facet joints degeneration, anterior or posterior bridging of the interspace or lack of motion on the pre-operative flexion/extension x-rays)
- Severe cervical myelopathy as indicated by: Signs and/or symptoms > 6months duration, Nurick's Classification grades IV or V, and/or Myelomalacia as evidence on a MRI
- Metabolic bone disease such as osteoporosis to a degree that spinal instrumentation is contra-indicated (Males over 55 years of age, females over 50 years of age and/or subjects that in the investigators opinion are medical indicative of osteoporosis (e.g. early menopause, steroid use, etc.) are required to have a DEXA scan; If the DEXA scan is ≤ -2.5t in the spine, the patient must be excluded)
- Allergy to any component of the device (titanium, polycarbonated polyurethane, polyethylene terephthalate, or ethylene oxide residuals)
- Chronic steroid or other medication use that may interfere with bony/soft tissue healing
- History of endocrine or metabolic disorders (e.g. Paget's disease) known to effect bone and mineral metabolism
- Autoimmune diseases e.g., ankylosing spondylitis, rheumatoid arthritis, etc.
- Insulin dependent diabetes mellitus
- Active malignancy
- Currently pregnant or considering becoming pregnant during the follow-up period
- Advanced emphysema, Alzheimer's disease or other medical conditions that would interfere with patient self-assessment of function, pain or quality of life
- Medical condition (e.g. unstable cardiac disease, end-stage cancer) that may result in patient death prior to study completion
- Chemical dependency (e.g. alcohol or narcotic addiction) problem that may interfere with study requirements
- Mental incompetence as determined by the Investigator which may effect participation in the study
- Incarcerated
- Involved in any current or pending litigation relating to a spinal condition
- Concurrently participating in any other investigational study
- Anatomy (e.g. endplate dimensions) at the index level not consistent with the dimensions of the implants available (e.g. based on pre-operative radiographic evaluations and templates in the surgical technique manual).
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00637312
Locations
| United States, California | |
| University of California Davis | |
| Sacramento, California, United States, 95816 | |
| United States, Colorado | |
| Boulder Neurosurgical Associates | |
| Boulder, Colorado, United States, 80304 | |
| United States, Florida | |
| University of South Florida | |
| Tampa, Florida, United States, 33606 | |
| United States, Louisiana | |
| Spine Institute of Louisiana | |
| Shreveport, Louisiana, United States, 71101 | |
| United States, Maryland | |
| Brain and Spine Specialist | |
| Baltimore, Maryland, United States, 21215 | |
| United States, New Jersey | |
| Cooper University Neurological Institute | |
| Camden, New Jersey, United States, 08103 | |
| United States, New York | |
| University of Rochester Medical Center | |
| Rochester, New York, United States, 14642 | |
| United States, North Carolina | |
| Triangle Orthopaedics Associates, P.A. | |
| Durham, North Carolina, United States, 27704 | |
| United States, Pennsylvania | |
| University of Pennsylvania, Department of Neurosurgery | |
| Philadelphia, Pennsylvania, United States, 19107 | |
| United States, South Carolina | |
| Medical University of South Carolina | |
| Charleston, South Carolina, United States, 29425 | |
| United States, Tennessee | |
| East Tennessee Brain and Spine Center | |
| Johnson City, Tennessee, United States, 37604 | |
| United States, Texas | |
| Texas Back Institute | |
| Plano, Texas, United States, 75093 | |
| The San Antonio Orthopaedic Group | |
| San Antonio, Texas, United States, 78216 | |
Sponsors and Collaborators
Orthofix Inc.
Investigators
| Study Director: | Scott L Blumenthal, M.D. | Texas Back Institute |
More Information
No publications provided
| Responsible Party: | Orthofix Inc. |
| ClinicalTrials.gov Identifier: | NCT00637312 History of Changes |
| Other Study ID Numbers: | CP-01003 |
| Study First Received: | March 10, 2008 |
| Last Updated: | October 10, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Spinal Diseases Intervertebral Disk Degeneration Bone Diseases Musculoskeletal Diseases |
ClinicalTrials.gov processed this record on May 22, 2013