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INFUSE™ BONE GRAFT/CORNERSTONE-SR™ Allograft Ring/ATLANTIS™ Anterior Cervical Plate- Pilot Study

Primary Purpose

Degenerative Cervical Disc Disease

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
INFUSE™ Bone Graft/CORNERSTONE-SR™ /ATLANTIS™
Autogenous bone/CORNERSTONE-SR™ /ATLANTIS™
Sponsored by
Medtronic Spinal and Biologics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Cervical Disc Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Cervical disc disease defined as: intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression which is documented by diagnostic imaging procedures:

    • herniated disc;
    • osteophyte formation;
    • decreased disc height;
    • thickening of ligamentous tissue;
    • disc degeneration; and/or
    • facet joint degeneration.
  2. Has preoperative Neck Disability Index score >= 30;
  3. C2-C3 disc to C7-Tl disc level(s) of involvement.
  4. One or two adjacent levels requiring fusion;
  5. No previous surgical intervention at the involved fusion level(s);
  6. Unresponsive to nonoperative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root or spinal cord compression in face of continued nonoperative management;
  7. Age > 18 years at time of surgery;
  8. Is female of child-bearing potential, who is not pregnant or nursing, and who agrees to not get pregnant for 1 year following surgery;
  9. Willingness to comply with study plan and sign the consent form.

Exclusion Criteria:

  1. Has cervical spinal condition requiring surgical treatment other than symptomatic cervical disc disease at the involved level(s).
  2. Has been previously diagnosed with osteopenia, osteoporosis, or osteomalacia to a degree that anterior plating would be contraindicated.
  3. Has presence of spinal metastases.
  4. Has overt or active bacterial infection, either local or systemic.
  5. Has fever (temperature > 101°F oral) at the time of surgery.
  6. Has a documented titanium alloy allergy or intolerance.
  7. Is mentally incompetent. If questionable, obtain psychiatric consult.
  8. Is a prisoner.
  9. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug usage.
  10. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal fusion surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs.
  11. Has a history of autoimmune disease (Systemic Lupus Erythematosus or Dermatomyositis).
  12. Has a history of exposure to injectable collagen implants.
  13. Has a history of hypersensitivity to protein pharmaceuticals (monoclonal antibodies or gamma globulins) or collagen.
  14. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following rhBMP-2/ACS implantation.
  15. Has received any previous exposure to any/all BMP's of either human or animal extraction.
  16. Has a history of allergy to bovine products or a history of anaphylaxis.
  17. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers- Danlos syndrome, or osteogenesis imperfecta).
  18. Has a condition which requires postoperative medications that interfere with fusion, such as steroids, excluding routine perioperative anti-inflammatory drugs.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    INFUSE™ Bone Graft/CORNERSTONE-SR™

    Autogenous bone/CORNERSTONE-SR™

    Arm Description

    Outcomes

    Primary Outcome Measures

    Fusion
    Fusion is defined as: No evidence of motion as defined by: less than 4° difference in angular motion between flexion and extension as seen on the lateral flexion/extension radiographs. No radiolucency greater than 2mm of thickness covering more than 50% of superior or inferior graft surface. Evidence of bridging trabecular bone.
    Pain/Disability Status
    The self-administered Neck Disability Index will be used. Success for each individual patient will be defined as pain/disability improvement postoperatively according to the following definition: Preoperative Score - Postoperative Score >= 15
    Neurological Status
    Neurological status will be assessed preoperatively and postoperatively using a comprehensive neurological status scale.

    Secondary Outcome Measures

    Time to fusion
    Hip (Donor Site) Pain
    General Health Status (SF-36)
    Pain Status (neck pain, arm pain)
    Patient Satisfaction
    Patient Global Perceived Effect

    Full Information

    First Posted
    December 12, 2011
    Last Updated
    May 16, 2023
    Sponsor
    Medtronic Spinal and Biologics
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01491399
    Brief Title
    INFUSE™ BONE GRAFT/CORNERSTONE-SR™ Allograft Ring/ATLANTIS™ Anterior Cervical Plate- Pilot Study
    Official Title
    Study of Recombinant Human Bone Morphogenetic Protein-2 and Absorbable Collagen Sponge With the CORNERSTONE-SR™Allograft Ring and ATLANTIS™ Anterior Cervical Plate System in Treatment of Patients With Degenerative Cervical Disc Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2023
    Overall Recruitment Status
    Completed
    Study Start Date
    September 1999 (undefined)
    Primary Completion Date
    March 2003 (Actual)
    Study Completion Date
    March 2003 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Medtronic Spinal and Biologics

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this clinical trial is to assess the safety and effectiveness of the Investigational implant as compared to the Control implant in the treatment of patients with one level or two adjacent levels of cervical symptomatic degenerative disc disease.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    33 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    INFUSE™ Bone Graft/CORNERSTONE-SR™
    Arm Type
    Experimental
    Arm Title
    Autogenous bone/CORNERSTONE-SR™
    Arm Type
    Active Comparator
    Intervention Type
    Device
    Intervention Name(s)
    INFUSE™ Bone Graft/CORNERSTONE-SR™ /ATLANTIS™
    Other Intervention Name(s)
    recombinant human Bone Morphogenetic Protein-2, Infuse
    Intervention Description
    Cornerstone-SR™ allograft bone containing recombinant human Bone Morphogenetic Protein (rhBMP-2) soaked into an absorbable collagen sponge (ACS) used in conjunction with ATLANTIS™ anterior cervical plate system.
    Intervention Type
    Device
    Intervention Name(s)
    Autogenous bone/CORNERSTONE-SR™ /ATLANTIS™
    Other Intervention Name(s)
    Autograft
    Intervention Description
    Cornerstone-SR™ allograft bone packed with autogenous iliac crest bone graft used in conjunction with ATLANTIS™ anterior cervical plate system.
    Primary Outcome Measure Information:
    Title
    Fusion
    Description
    Fusion is defined as: No evidence of motion as defined by: less than 4° difference in angular motion between flexion and extension as seen on the lateral flexion/extension radiographs. No radiolucency greater than 2mm of thickness covering more than 50% of superior or inferior graft surface. Evidence of bridging trabecular bone.
    Time Frame
    24 month
    Title
    Pain/Disability Status
    Description
    The self-administered Neck Disability Index will be used. Success for each individual patient will be defined as pain/disability improvement postoperatively according to the following definition: Preoperative Score - Postoperative Score >= 15
    Time Frame
    24 month
    Title
    Neurological Status
    Description
    Neurological status will be assessed preoperatively and postoperatively using a comprehensive neurological status scale.
    Time Frame
    24 month
    Secondary Outcome Measure Information:
    Title
    Time to fusion
    Time Frame
    24 month
    Title
    Hip (Donor Site) Pain
    Time Frame
    24 month
    Title
    General Health Status (SF-36)
    Time Frame
    24 month
    Title
    Pain Status (neck pain, arm pain)
    Time Frame
    24 month
    Title
    Patient Satisfaction
    Time Frame
    24 month
    Title
    Patient Global Perceived Effect
    Time Frame
    24 month

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Cervical disc disease defined as: intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression which is documented by diagnostic imaging procedures: herniated disc; osteophyte formation; decreased disc height; thickening of ligamentous tissue; disc degeneration; and/or facet joint degeneration. Has preoperative Neck Disability Index score >= 30; C2-C3 disc to C7-Tl disc level(s) of involvement. One or two adjacent levels requiring fusion; No previous surgical intervention at the involved fusion level(s); Unresponsive to nonoperative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root or spinal cord compression in face of continued nonoperative management; Age > 18 years at time of surgery; Is female of child-bearing potential, who is not pregnant or nursing, and who agrees to not get pregnant for 1 year following surgery; Willingness to comply with study plan and sign the consent form. Exclusion Criteria: Has cervical spinal condition requiring surgical treatment other than symptomatic cervical disc disease at the involved level(s). Has been previously diagnosed with osteopenia, osteoporosis, or osteomalacia to a degree that anterior plating would be contraindicated. Has presence of spinal metastases. Has overt or active bacterial infection, either local or systemic. Has fever (temperature > 101°F oral) at the time of surgery. Has a documented titanium alloy allergy or intolerance. Is mentally incompetent. If questionable, obtain psychiatric consult. Is a prisoner. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug usage. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal fusion surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs. Has a history of autoimmune disease (Systemic Lupus Erythematosus or Dermatomyositis). Has a history of exposure to injectable collagen implants. Has a history of hypersensitivity to protein pharmaceuticals (monoclonal antibodies or gamma globulins) or collagen. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following rhBMP-2/ACS implantation. Has received any previous exposure to any/all BMP's of either human or animal extraction. Has a history of allergy to bovine products or a history of anaphylaxis. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers- Danlos syndrome, or osteogenesis imperfecta). Has a condition which requires postoperative medications that interfere with fusion, such as steroids, excluding routine perioperative anti-inflammatory drugs.

    12. IPD Sharing Statement

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    INFUSE™ BONE GRAFT/CORNERSTONE-SR™ Allograft Ring/ATLANTIS™ Anterior Cervical Plate- Pilot Study

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