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Evaluation of Radiographic and Patient Outcomes Following Lumbar Spine Fusion Using Demineralized Bone Matrix (DBM) Mixed With Autograft

Primary Purpose

Stenosis, Spondylolisthesis, Degenerative Disc Disease

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Posterior Lateral Fusion (PLF)
Anterior Lumbar Interbody Fusion (ALIF)
Transforaminal lumbar interbody fusion (TLIF)
Posterior lumbar interbody fusion (PLIF)
Extreme lateral interbody fusion (XLIF)
Sponsored by
Exactech
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stenosis focused on measuring Primary lumbar fusion, Demineralized Bone Matrix, DBM, Optecure, Allograft, Autograft, Lumbar fusion, Interbody fusion, Instrumented fusion, Non-instrumented fusion, Exactech, Spinal fusion

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patient is indicated for primary lumbar fusion of 1 or 2 segments, L2 to S1 Patient is willing to be blindly randomized to treatment or control and remain blinded for 2 years of follow-up Patient is at least twenty-one (21) years of age Patient is expected to survive at least 2 years beyond surgery Patient is willing to participate by complying with pre- and postoperative visit requirements, including: completion of questionnaires, functional performance tests, and radiographs/CT scan Patient is willing and able to review and sign a study Informed Consent form Exclusion Criteria: Patient has a mental or physical condition that would invalidate evaluation results Patient is pregnant Patient is a prisoner Patient has a systemic infection or infection at the proposed surgical site Patient has osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated Patient has a disease of bone metabolism Patient is undergoing chemotherapy or radiation treatment Patient is currently involved in a study of another product for a similar purpose Patient requires post-op management with nonsteroidal anti-inflammatory drugs (NSAIDs)

Sites / Locations

  • Memorial Orthopaedic Surgical Group
  • University of California, San Diego
  • Slocum Dickson Medical Group
  • State University of New York, Upstate Medical University
  • NeuroSpine Solutions, P.C.
  • Madigan Army Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

O

A

Arm Description

This treatment arm includes autograft harvested from local bone and / or the iliac crest, supplemented with a demineralized bone matrix (DBM) autograft extender, Optecure.

This treatment arm includes autograft harvested from local bone and / or the iliac crest.

Outcomes

Primary Outcome Measures

Radiographic evidence of fusion on x-rays taken at each post-op visit

Secondary Outcome Measures

Oswestry Disability Index (ODI) completed at each visit
SF-12 patient health surveys completed at each visit
Perceived pain noted on visual analog scales (VAS) at each visit

Full Information

First Posted
November 15, 2005
Last Updated
November 20, 2013
Sponsor
Exactech
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1. Study Identification

Unique Protocol Identification Number
NCT00254852
Brief Title
Evaluation of Radiographic and Patient Outcomes Following Lumbar Spine Fusion Using Demineralized Bone Matrix (DBM) Mixed With Autograft
Official Title
A Single Blind, Multi-Center, Randomized, Prospective Clinical Study Comparing Optecure™ Autograft Extender to Autograft Only in Fusion of the Lumbar Spine
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Terminated
Why Stopped
Slow enrollment
Study Start Date
October 2005 (undefined)
Primary Completion Date
August 2011 (Actual)
Study Completion Date
August 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Exactech

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare Optecure™ as an autograft extender (treatment) to autograft alone (control) in patients undergoing 1 or 2 level fusion of the lumbar spine(one level is defined as two adjacent vertebrae), L2 and below. The primary endpoint will be the assessment of fusion by evaluation of x-rays taken following surgery at each visit. The x-ray evaluation will be conducted by a radiologist who is blinded to the type of treatment each patient has received. Subjects will be seen at 6 weeks, 3 months, 6 months, 12 months, and 24 months postoperative (post-op). Questionnaires and x-rays will be completed at each visit and a computed tomography (CT) scan will be taken at the 12 month visit(and used to aid in assessment of bridging bone, where appropriate).
Detailed Description
Autograft (bone taken from one part of the body and placed in another site on the same individual) has long been considered the gold standard for lumbar spine fusion procedures. Unfortunately, there are complications involved with autograft harvest such as donor site morbidity, increased operating time, and limited supply. Therefore, the use of allograft (bone taken from one body and placed into another individual) as a graft extender has become an acceptable practice, especially in fusions of more than one level where larger quantities of graft material are needed. In this study, comparisons will be made between patients who are randomized to having fusion with an allograft material (Optecure, Exactech, Inc.) mixed with an autograft to those patients who are randomized to having fusion with autograft alone.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stenosis, Spondylolisthesis, Degenerative Disc Disease
Keywords
Primary lumbar fusion, Demineralized Bone Matrix, DBM, Optecure, Allograft, Autograft, Lumbar fusion, Interbody fusion, Instrumented fusion, Non-instrumented fusion, Exactech, Spinal fusion

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
94 (Actual)

8. Arms, Groups, and Interventions

Arm Title
O
Arm Type
Active Comparator
Arm Description
This treatment arm includes autograft harvested from local bone and / or the iliac crest, supplemented with a demineralized bone matrix (DBM) autograft extender, Optecure.
Arm Title
A
Arm Type
Active Comparator
Arm Description
This treatment arm includes autograft harvested from local bone and / or the iliac crest.
Intervention Type
Procedure
Intervention Name(s)
Posterior Lateral Fusion (PLF)
Other Intervention Name(s)
PLF
Intervention Description
Posterior lateral fusion (PLF) of the lumbar spine
Intervention Type
Procedure
Intervention Name(s)
Anterior Lumbar Interbody Fusion (ALIF)
Other Intervention Name(s)
ALIF
Intervention Description
Anterior lumbar interbody fusion (ALIF)
Intervention Type
Procedure
Intervention Name(s)
Transforaminal lumbar interbody fusion (TLIF)
Other Intervention Name(s)
TLIF
Intervention Description
Transforaminal lumbar interbody fusion (TLIF)
Intervention Type
Procedure
Intervention Name(s)
Posterior lumbar interbody fusion (PLIF)
Other Intervention Name(s)
PLIF
Intervention Description
Posterior lumbar interbody fusion (PLIF)
Intervention Type
Procedure
Intervention Name(s)
Extreme lateral interbody fusion (XLIF)
Other Intervention Name(s)
XLIF
Intervention Description
Extreme lateral interbody fusion (XLIF)
Primary Outcome Measure Information:
Title
Radiographic evidence of fusion on x-rays taken at each post-op visit
Time Frame
Immediate post-op, 6-week, 3-month, 6-month, 1-year, 2-year
Secondary Outcome Measure Information:
Title
Oswestry Disability Index (ODI) completed at each visit
Time Frame
pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year
Title
SF-12 patient health surveys completed at each visit
Time Frame
Pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year
Title
Perceived pain noted on visual analog scales (VAS) at each visit
Time Frame
Pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is indicated for primary lumbar fusion of 1 or 2 segments, L2 to S1 Patient is willing to be blindly randomized to treatment or control and remain blinded for 2 years of follow-up Patient is at least twenty-one (21) years of age Patient is expected to survive at least 2 years beyond surgery Patient is willing to participate by complying with pre- and postoperative visit requirements, including: completion of questionnaires, functional performance tests, and radiographs/CT scan Patient is willing and able to review and sign a study Informed Consent form Exclusion Criteria: Patient has a mental or physical condition that would invalidate evaluation results Patient is pregnant Patient is a prisoner Patient has a systemic infection or infection at the proposed surgical site Patient has osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated Patient has a disease of bone metabolism Patient is undergoing chemotherapy or radiation treatment Patient is currently involved in a study of another product for a similar purpose Patient requires post-op management with nonsteroidal anti-inflammatory drugs (NSAIDs)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amir Fayyazi, MD
Organizational Affiliation
VSAS Orthopedics
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Orthopaedic Surgical Group
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
University of California, San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Slocum Dickson Medical Group
City
New Hartford
State/Province
New York
ZIP/Postal Code
13413
Country
United States
Facility Name
State University of New York, Upstate Medical University
City
Syracuse
State/Province
New York
ZIP/Postal Code
13202
Country
United States
Facility Name
NeuroSpine Solutions, P.C.
City
Bristol
State/Province
Tennessee
ZIP/Postal Code
37620
Country
United States
Facility Name
Madigan Army Medical Center
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98431
Country
United States

12. IPD Sharing Statement

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Evaluation of Radiographic and Patient Outcomes Following Lumbar Spine Fusion Using Demineralized Bone Matrix (DBM) Mixed With Autograft

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