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Evaluating The Safety and Effectiveness of The NeoDisc™ Versus ACDF in Subjects With Single-Level Cervical Disc Disease (NeoDisc™)

Primary Purpose

Cervical Disc Degenerative Disorder

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NeoDisc
Instrumented Anterior Cervical Discectomy and Fusion (ACDF)
Sponsored by
NuVasive
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Disc Degenerative Disorder focused on measuring Single Level, Cervical Disc Disease

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • 18-60 years of age (inclusive and skeletally mature)
  • Diagnosis of symptomatic cervical disc disease, defined as image- confirmed pathology: herniated disc, spondylosis, and/or loss of disc height. Spondylosis is defined as MRI or CT-confirmed disc dessication, loss of disc height, bridging osteophytes, and/or uncovertebral arthrosis. Loss of disc height is specified as a measurement of at least 25% less than an adjacent nonsymptomatic level, but with a minimum of 1mm height remaining.
  • Functional neurological deficit (i.e., exhibits at least one sign associated with cervical level to be treated, including abnormal reflex, decreased motor strength, abnormal dermatome sensitivity, or pain in a dermatomal distribution)
  • Symptomatic level is C3-4, C4-5, C5-6 or C6-7 (one level)
  • Preop NDI ≥30 points
  • Unresponsive to conservative treatment for ≥6 wks, or exhibits progressive symptoms or signs of nerve root or spinal cord compression in the face of conservative treatment
  • Not pregnant, nor interested in becoming pregnant within the follow-up period of the study
  • Willing and able to comply with the requirements defined in the protocol for the duration of the study
  • Signed and dated Informed Consent

Exclusion Criteria:

  • Prior cervical fusion surgery at the operative level
  • Prior cervical laminectomy at the operative level (prior cervical laminotomy need not be excluded)
  • Prior cervical complete facetectomy at the operative level
  • Requiring surgical treatment that would leave the patient with a postoperative deficiency of the posterior elements
  • Radiographic signs of significant instability at operative level (greater than 3mm translation, > 11 degrees rotation different from adjacent level)
  • Bridging osteophytes or motion < 2 degrees
  • Radiographic confirmation of significant facet joint disease or degeneration
  • Chronic neck or arm pain of unknown etiology
  • Clinically significant symptomatic myelopathy (e.g., those with signal changes in the spinal cord on preoperative T2-weighted MRI)
  • Cervical fracture, anatomic anomaly, or deformity (e.g. ankylosing spondylitis, scoliosis) at the levels to which the prosthesis will be attached
  • Severe spondylolisthesis (>grade 1)
  • Endocrine disorders or connective tissue diseases
  • Rheumatoid arthritis or other autoimmune disease
  • Progressive neuromuscular disease, e.g., muscular dystrophy, multiple sclerosis
  • Chronic steroid users
  • Taking any medications or drugs that are known to potentially interfere with the bone metabolism or soft tissue healing, which may include (but is not limited to) the following: inhaled glucocorticoids for asthma, corticosteroids, thyroid hormones, blood thinners (heparin, warfarin), gonadotropin-releasing hormone agonists for prostate cancer treatment, contraceptive medroxyprogesterone, lithium for bi-polar disorder treatment, anticonvulsants, aluminum-containing antacids, tetracycline
  • Osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated (DEXA T-score less than or equal to -2.5; DEXA necessary only if patient exhibits risk factors for low bone mass as quantified in DEXA screening questionnaire).
  • Diabetes mellitus requiring insulin management
  • Presence of metastases or active spinal tumor malignancy
  • Body Mass Index (BMI) > 40
  • Active local or systemic infection, including AIDS, hepatitis
  • Having been enrolled in another investigational device study within the last 90 days
  • Having had another cervical device implanted that would interfere with the surgical approach, study or control device, or follow-up evaluations.
  • Demonstrates signs of nonorganic behavior, such as Waddell's signs
  • History of substance abuse
  • Involved in spinal litigation
  • Mentally incompetent
  • Incarcerated

Sites / Locations

  • San Diego Center for Spinal Disorders
  • Diagnostic and Interventional Surgical Center
  • The Spine Institute
  • Spine Colorado / Durango Orthopedic Associates
  • Rocky Mountain Spine Arthroplasty (RMA Ortho)
  • Florida Spine Specialists
  • Florida Research Network, LLC
  • Lyerly Baptist
  • Optim Healthcare
  • OAD Orthopaedics
  • OrthoIndy
  • Spine Midwest, Inc
  • Western Regional Spine Center for Brain and Spine Surgery
  • Coastal Spine
  • Capital Neurosurgery
  • Center for Advanced Orthopaedics/Adena Health Pavillon
  • Neurological Associates
  • Central Ohio Neurological Surgeons
  • Orthopedic Spine Associates
  • Southern Oregon Orthopedics
  • Central Texas Spine Institute
  • Salt Lake Orthopaedic Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

NeoDisc

ACDF

Outcomes

Primary Outcome Measures

Improve in NDI by ≥ 15 pnts at 24 mo compared to Baseline; No device failures requiring revision, re-op or removal; No major complications,i.e.,vascular or neurological injury; Maintenance or improvement of neurologic status

Secondary Outcome Measures

ROM; Fusion/migration of device; SF-36 imp of ≥15% at 24 months comp to Baseline; VAS imp of > 20 mm at 24 months comp to Baseline; Disc ht from lateral x-ray showing maintenance or imp from Baseline at 24

Full Information

First Posted
May 22, 2007
Last Updated
May 30, 2012
Sponsor
NuVasive
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1. Study Identification

Unique Protocol Identification Number
NCT00478088
Brief Title
Evaluating The Safety and Effectiveness of The NeoDisc™ Versus ACDF in Subjects With Single-Level Cervical Disc Disease
Acronym
NeoDisc™
Official Title
A Pivotal, Multi-Center, Randomized, Controlled Trial Evaluating The Safety and Effectiveness of The NeoDisc™ Versus Instrumented Anterior Cervical Discectomy and Fusion (ACDF) in Subjects With Single-Level Cervical Disc Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
September 2006 (undefined)
Primary Completion Date
August 2010 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to evaluate the safety and effectiveness of the NeoDisc compared to anterior cervical discectomy and fusion (ACDF) for the treatment of single-level cervical disc disease, by demonstrating non-inferior comparative results at the 24 month follow-up period pertaining to (1) improvement in the Neck Disability Index (NDI) score, (2) revision/reoperation/removal rate, (3) complication rate, and (4) maintenance or improvement in neurologic status.
Detailed Description
The NeoDisc is an artificial cervical intervertebral disc replacement intended for clinical use following a discectomy. Implantation of the device will result in artificial replacement of a pathologically damaged or surgically removed cervical disc. Use of the device also obviates the need to harvest bone graft from the patient's iliac crest, a common and painful part of current surgical techniques. The NeoDisc is indicated for cervical spinal arthroplasty in skeletally mature subjects with symptomatic cervical disc disease at one level from C3 to C7. Symptomatic cervical disc disease is defined as image-confirmed herniated disc, spondylosis, and/or loss of disc height, with functional neurological deficit (i.e., exhibits at least one sign associated with cervical level to be treated, including abnormal reflex, decreased motor strength, abnormal dermatome sensitivity, or pain in a dermatomal distribution).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Disc Degenerative Disorder
Keywords
Single Level, Cervical Disc Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
NeoDisc
Arm Title
2
Arm Type
Active Comparator
Arm Description
ACDF
Intervention Type
Device
Intervention Name(s)
NeoDisc
Intervention Description
The NeoDisc is an artificial cervical intervertebral disc replacement intended for clinical use following a discectomy.
Intervention Type
Device
Intervention Name(s)
Instrumented Anterior Cervical Discectomy and Fusion (ACDF)
Intervention Description
Surgical removal of the cervical disc, decompression, and anterior implantation of allograft bone with a cervical plate.
Primary Outcome Measure Information:
Title
Improve in NDI by ≥ 15 pnts at 24 mo compared to Baseline; No device failures requiring revision, re-op or removal; No major complications,i.e.,vascular or neurological injury; Maintenance or improvement of neurologic status
Time Frame
August 2010
Secondary Outcome Measure Information:
Title
ROM; Fusion/migration of device; SF-36 imp of ≥15% at 24 months comp to Baseline; VAS imp of > 20 mm at 24 months comp to Baseline; Disc ht from lateral x-ray showing maintenance or imp from Baseline at 24
Time Frame
August 2010

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 18-60 years of age (inclusive and skeletally mature) Diagnosis of symptomatic cervical disc disease, defined as image- confirmed pathology: herniated disc, spondylosis, and/or loss of disc height. Spondylosis is defined as MRI or CT-confirmed disc dessication, loss of disc height, bridging osteophytes, and/or uncovertebral arthrosis. Loss of disc height is specified as a measurement of at least 25% less than an adjacent nonsymptomatic level, but with a minimum of 1mm height remaining. Functional neurological deficit (i.e., exhibits at least one sign associated with cervical level to be treated, including abnormal reflex, decreased motor strength, abnormal dermatome sensitivity, or pain in a dermatomal distribution) Symptomatic level is C3-4, C4-5, C5-6 or C6-7 (one level) Preop NDI ≥30 points Unresponsive to conservative treatment for ≥6 wks, or exhibits progressive symptoms or signs of nerve root or spinal cord compression in the face of conservative treatment Not pregnant, nor interested in becoming pregnant within the follow-up period of the study Willing and able to comply with the requirements defined in the protocol for the duration of the study Signed and dated Informed Consent Exclusion Criteria: Prior cervical fusion surgery at the operative level Prior cervical laminectomy at the operative level (prior cervical laminotomy need not be excluded) Prior cervical complete facetectomy at the operative level Requiring surgical treatment that would leave the patient with a postoperative deficiency of the posterior elements Radiographic signs of significant instability at operative level (greater than 3mm translation, > 11 degrees rotation different from adjacent level) Bridging osteophytes or motion < 2 degrees Radiographic confirmation of significant facet joint disease or degeneration Chronic neck or arm pain of unknown etiology Clinically significant symptomatic myelopathy (e.g., those with signal changes in the spinal cord on preoperative T2-weighted MRI) Cervical fracture, anatomic anomaly, or deformity (e.g. ankylosing spondylitis, scoliosis) at the levels to which the prosthesis will be attached Severe spondylolisthesis (>grade 1) Endocrine disorders or connective tissue diseases Rheumatoid arthritis or other autoimmune disease Progressive neuromuscular disease, e.g., muscular dystrophy, multiple sclerosis Chronic steroid users Taking any medications or drugs that are known to potentially interfere with the bone metabolism or soft tissue healing, which may include (but is not limited to) the following: inhaled glucocorticoids for asthma, corticosteroids, thyroid hormones, blood thinners (heparin, warfarin), gonadotropin-releasing hormone agonists for prostate cancer treatment, contraceptive medroxyprogesterone, lithium for bi-polar disorder treatment, anticonvulsants, aluminum-containing antacids, tetracycline Osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated (DEXA T-score less than or equal to -2.5; DEXA necessary only if patient exhibits risk factors for low bone mass as quantified in DEXA screening questionnaire). Diabetes mellitus requiring insulin management Presence of metastases or active spinal tumor malignancy Body Mass Index (BMI) > 40 Active local or systemic infection, including AIDS, hepatitis Having been enrolled in another investigational device study within the last 90 days Having had another cervical device implanted that would interfere with the surgical approach, study or control device, or follow-up evaluations. Demonstrates signs of nonorganic behavior, such as Waddell's signs History of substance abuse Involved in spinal litigation Mentally incompetent Incarcerated
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Kitchel, MD
Organizational Affiliation
Medical Monitor
Official's Role
Principal Investigator
Facility Information:
Facility Name
San Diego Center for Spinal Disorders
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Diagnostic and Interventional Surgical Center
City
Marina del Rey
State/Province
California
ZIP/Postal Code
90245
Country
United States
Facility Name
The Spine Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Spine Colorado / Durango Orthopedic Associates
City
Durango
State/Province
Colorado
ZIP/Postal Code
81301
Country
United States
Facility Name
Rocky Mountain Spine Arthroplasty (RMA Ortho)
City
Loveland
State/Province
Colorado
ZIP/Postal Code
80538
Country
United States
Facility Name
Florida Spine Specialists
City
Ft. Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
Florida Research Network, LLC
City
Gainsville
State/Province
Florida
ZIP/Postal Code
32605
Country
United States
Facility Name
Lyerly Baptist
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Optim Healthcare
City
Savannah
State/Province
Georgia
ZIP/Postal Code
31405
Country
United States
Facility Name
OAD Orthopaedics
City
Warrenville
State/Province
Illinois
ZIP/Postal Code
60555
Country
United States
Facility Name
OrthoIndy
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46278
Country
United States
Facility Name
Spine Midwest, Inc
City
Jefferson City
State/Province
Missouri
ZIP/Postal Code
65101
Country
United States
Facility Name
Western Regional Spine Center for Brain and Spine Surgery
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89109
Country
United States
Facility Name
Coastal Spine
City
Mount Laurel
State/Province
New Jersey
ZIP/Postal Code
08054
Country
United States
Facility Name
Capital Neurosurgery
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
Center for Advanced Orthopaedics/Adena Health Pavillon
City
Chillicothe
State/Province
Ohio
ZIP/Postal Code
45601
Country
United States
Facility Name
Neurological Associates
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43221
Country
United States
Facility Name
Central Ohio Neurological Surgeons
City
Westerville
State/Province
Ohio
ZIP/Postal Code
43081
Country
United States
Facility Name
Orthopedic Spine Associates
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Facility Name
Southern Oregon Orthopedics
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Central Texas Spine Institute
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States
Facility Name
Salt Lake Orthopaedic Clinic
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
82124
Country
United States

12. IPD Sharing Statement

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Evaluating The Safety and Effectiveness of The NeoDisc™ Versus ACDF in Subjects With Single-Level Cervical Disc Disease

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