Optimal Treatment for Spinal Cord Injury Associated With Cervical Canal Stenosis (OSCIS) Study
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Purpose
Controversy exists regarding the optimal management of acute traumatic cervical spinal cord injury (SCI), especially those without bone injury. Although surgical decompression is often performed in SCI patients with cervical canal stenosis, efficacy and timing of surgery continues to be a subject of intense debate. In this randomized controlled trial, the investigators compare two strategies: early surgery within 24 hours after admission and delayed surgery following at least 2 weeks of conservative treatment. The purpose of this study is to examine whether early surgery would result in greater improvement in motor function as compared with delayed surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Spinal Cord Injury |
Procedure: Early surgery Procedure: Delayed surgery |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Trial of Early Versus Delayed Surgery for Acute Traumatic Cervical Spinal Cord Injury Without Bone Injury in Patients With Cervical Canal Stenosis |
- ASIA motor score [ Time Frame: baseline and one year ] [ Designated as safety issue: No ]change from baseline to one year in the American Spinal Injury Association (ASIA) motor score
- the ability to walk without assistance [ Time Frame: one year ] [ Designated as safety issue: No ]proportion of patients who regained the ability to walk without assistance
- Spinal Cord Independence Measure (SCIM) [ Time Frame: one year ] [ Designated as safety issue: No ]the total score of the Spinal Cord Independence Measure (SCIM) version 3
- Health-related quality of life [ Time Frame: one year ] [ Designated as safety issue: No ]SF-36 EQ-5D
- Neuropathic pain [ Time Frame: one year ] [ Designated as safety issue: No ]Neuropathic Pain Symptom Inventory
- Walking status [ Time Frame: one year ] [ Designated as safety issue: No ]Walking Index for Spinal Cord Injury (WISCI) II
| Estimated Enrollment: | 100 |
| Study Start Date: | December 2011 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Early surgery |
Procedure: Early surgery
Surgery within 24 hours after admission
|
| Active Comparator: Delayed surgery |
Procedure: Delayed surgery
Surgery more than 2 weeks after injury
|
Eligibility| Ages Eligible for Study: | 20 Years to 79 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients with acute traumatic cervical spinal cord injury (at C5 or below) admitted within 48 hours after injury
- No bone injury (no fracture or instability)
- American Spinal Injury Association (ASIA) Impairment Grade C
- Cervical canal stenosis due to preexisting conditions such as spondylosis and ossification of the posterior longitudinal ligament (OPLL)
Exclusion Criteria:
- Unstable medical status
- Difficult to undergo surgery within 24 hours after admission
- Impaired consciousness or mental disorder that precludes neurological examination
- Difficult to obtain informed consent in Japanese
Contacts and Locations| Contact: Hirotaka Chikuda, MD, PhD | +81-3-3815-5411 ext 33376 | oscis-core@umin.ac.jp |
| Japan | |
| The University of Tokyo | Recruiting |
| Tokyo, Japan | |
| Contact: Hirotaka Chikuda, MD, PhD +81-3-3815-5411 ext 33376 oscis-core@umin.ac.jp | |
| Principal Investigator: | Hirotaka Chikuda, MD, PhD | The University of Tokyo |
More Information
No publications provided
| Responsible Party: | Tokyo University |
| ClinicalTrials.gov Identifier: | NCT01485458 History of Changes |
| Other Study ID Numbers: | OSCIS, UMIN000006780 |
| Study First Received: | November 30, 2011 |
| Last Updated: | December 3, 2011 |
| Health Authority: | Japan: Ministry of Health, Labor and Welfare |
Keywords provided by Tokyo University:
|
Incomplete spinal cord injury Cervical canal stenosis Ossification of the posterior longitudinal ligament Surgery Decompression |
Additional relevant MeSH terms:
|
Spinal Cord Injuries Spinal Cord Diseases Central Nervous System Diseases |
Nervous System Diseases Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on May 19, 2013