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Safety And Performance Of Disc Care To Prevent Lumbar Disc Herniation Recurrence (ACE-2)

Primary Purpose

Disc Herniation, Disk Herniated Lumbar

Status
Recruiting
Phase
Not Applicable
Locations
Spain
Study Type
Interventional
Intervention
DISC Care
Sponsored by
NEOS Surgery
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Disc Herniation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Subject is between 18 and 75 years old. Posterolateral disc hernia between levels L4 and S1 with radiological (CT scan or MRI) confirmation of neural compression. At least six weeks of failed conservative treatment prior to surgery, including physical therapy, use of anti-inflammatory medications at maximum specified dosage and/or administration of epidural/facet injections. Minimum posterior disc height of 5 mm at the index level. Radiculopathy with positive straight leg raise test. ODI score of at least 30/100. Subjects who are able to give voluntary informed consent to participate in the clinical investigation and from whom consent has been obtained. Subject is able and willing to comply with the protocol requirements. Exclusion Criteria: Spondylolisthesis and/or instability at the index level that, in the judgement of the surgeon, could affect the device implantation. Central, foraminal or extraforaminal disc hernia. Subject has vertebral bodies of the index level affected by any traumatic, neoplastic, metabolic, or infectious pathology. Subject has scoliosis of greater than 20 degrees (both angular and rotational). Grossly distorted anatomy due to congenital abnormalities. Deformation that affects the posterior corners of the vertebra at the index level (e.g., osteophytes) that, in the judgment of the surgeon, could affect the device implantation. Endplate irregularities that, in the judgment of the surgeon, could affect the device implantation. Prior surgery at the index lumbar vertebral level that, in the judgment of the surgeon, could affect the device implantation. Radiological confirmation of severe facet joint disease or degeneration. Patients diagnosed or at a high risk of osteoporosis (such as postmenopausal women and patients receiving long-term treatment with corticosteroids) who present a bone densitometry DXA (dual energy x-ray absorptiometry) T-score of less than -2.0 at the index level. Cauda equina syndrome. Fever, leucocytosis and/or systemic or localized active infection. Systemic inflammation and/or inflammation at the implantation site. Any uncontrolled metabolic bone disease that affects the spine. Uncontrolled insulin-dependent diabetes mellitus. Peripheral neuropathy. Active hepatitis, AIDS or HIV. Rheumatoid arthritis or other autoimmune disease that affects the spine joints. Active or history of any invasive malignancy; patients with curatively-treated malignancies who have been disease-free for at least 5 years are eligible. Uncontrolled active tuberculosis or history of uncontrolled tuberculosis in the past 3 years. Immunologically suppressed patients. Current anticoagulation therapy, unless anticoagulation therapy can be suspended for surgery. Patients who have received medication (e.g., methotrexate, alendronate) that interferes with bone mineral metabolism within 4 weeks of the planned date of the index surgery. Suspected or known allergies or intolerance to the device materials: titanium, nitinol, stainless steel, polyetheretherketone and polyethylene terephthalate. Any condition that precludes the use of general anaesthesia. Any condition that precludes the surgical procedure. Any contraindication for MRI or CT scan. Class III obesity: Body mass index ≥ 40. Current alcohol or recreational drug dependency. Pregnant or interested in becoming pregnant in the following 24 months. Breastfeeding. Life expectancy less than 2 years. Subject is currently participating or has participated in the previous 4 weeks in any other interventional clinical study.

Sites / Locations

  • Hospital Universitari de BellvitgeRecruiting
  • Hospital QuirónSalud BarcelonaRecruiting
  • Hospital Universitario de Canarias
  • Hospital La Princesa
  • Hospital General Universitario Gregorio Marañón
  • Hospital Universitario Fundación Jiménez Díaz
  • Hospital Universitario la PazRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DISC Care

Arm Description

DISC Care implant

Outcomes

Primary Outcome Measures

Incidence of clinically symptomatic recurrent lumbar disc herniation

Secondary Outcome Measures

Incidence and type of all adverse events (AE) and serious adverse events (SAE).
Incidence of clinically asymptomatic recurrent disc herniation
Incidence of re-interventions
Disc height maintenance [mm] related to baseline
Change in leg and low back pain, related to baseline
0-10 NRS (numeric rating scale)
Change in Low back related disability, related to baseline
Oswestry Disability Index (ODI)
The change in quality of life, compared to baseline
EQ-5D-5L (5-level EQ-5D version)
The change in patient neurological status, compared to baseline
straight leg raise test, reflexes, motor muscle strength and sensory neurological evaluations, classified as normal or abnormal
The degeneration of the disc, in comparison with the preoperative state
Pfirrmann intervertebral disc degeneration scale (I, II, III, IV, V)
the direct and indirect costs of the disease and the intervention.
Custom-made questionnaire

Full Information

First Posted
August 2, 2023
Last Updated
October 17, 2023
Sponsor
NEOS Surgery
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1. Study Identification

Unique Protocol Identification Number
NCT06023719
Brief Title
Safety And Performance Of Disc Care To Prevent Lumbar Disc Herniation Recurrence
Acronym
ACE-2
Official Title
Multicentric Clinical Investigation To Assess The Safety And Performance Of Disc Care To Prevent Lumbar Disc Herniation Recurrence
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2023 (Anticipated)
Primary Completion Date
September 2026 (Anticipated)
Study Completion Date
September 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NEOS Surgery

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this clinical investigation is to learn about DISC Care, an Hernia Blocking System, in patients who have undergone lumbar disc hernia surgery. The main questions it aims to answer are: if the implant (DISC Care) prevents disc herniation recurrence if DISC Care is a safe device Participants will be implanted with DISC Care and followed up for two years (7 visits).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Disc Herniation, Disk Herniated Lumbar

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DISC Care
Arm Type
Experimental
Arm Description
DISC Care implant
Intervention Type
Device
Intervention Name(s)
DISC Care
Other Intervention Name(s)
Hernia Blocking System
Intervention Description
Medical device to prevent disc herniation recurrence
Primary Outcome Measure Information:
Title
Incidence of clinically symptomatic recurrent lumbar disc herniation
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Incidence and type of all adverse events (AE) and serious adverse events (SAE).
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
Incidence of clinically asymptomatic recurrent disc herniation
Time Frame
6 months, 12 months, and 24 months
Title
Incidence of re-interventions
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
Disc height maintenance [mm] related to baseline
Time Frame
6 months, 12 months, and 24 months
Title
Change in leg and low back pain, related to baseline
Description
0-10 NRS (numeric rating scale)
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
Change in Low back related disability, related to baseline
Description
Oswestry Disability Index (ODI)
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
The change in quality of life, compared to baseline
Description
EQ-5D-5L (5-level EQ-5D version)
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
The change in patient neurological status, compared to baseline
Description
straight leg raise test, reflexes, motor muscle strength and sensory neurological evaluations, classified as normal or abnormal
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Title
The degeneration of the disc, in comparison with the preoperative state
Description
Pfirrmann intervertebral disc degeneration scale (I, II, III, IV, V)
Time Frame
6 months, 12 months, and 24 months
Title
the direct and indirect costs of the disease and the intervention.
Description
Custom-made questionnaire
Time Frame
6 weeks, 6 months, 12 months, and 24 months
Other Pre-specified Outcome Measures:
Title
Description of the impact of the procedure (implantation of the device) on the perioperative parameters
Description
Blood loss (mL)
Time Frame
Surgery
Title
Description of the impact of the procedure (implantation of the device) on the perioperative parameters
Description
X-ray exposition (seconds of x-ray exposition)
Time Frame
Surgery
Title
Description of the impact of the procedure (implantation of the device) on the perioperative parameters
Description
Surgery duration (minutes)
Time Frame
Surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is between 18 and 75 years old. Posterolateral disc hernia between levels L4 and S1 with radiological (CT scan or MRI) confirmation of neural compression. At least six weeks of failed conservative treatment prior to surgery, including physical therapy, use of anti-inflammatory medications at maximum specified dosage and/or administration of epidural/facet injections. Minimum posterior disc height of 5 mm at the index level. Radiculopathy with positive straight leg raise test. ODI score of at least 30/100. Subjects who are able to give voluntary informed consent to participate in the clinical investigation and from whom consent has been obtained. Subject is able and willing to comply with the protocol requirements. Exclusion Criteria: Spondylolisthesis and/or instability at the index level that, in the judgement of the surgeon, could affect the device implantation. Central, foraminal or extraforaminal disc hernia. Subject has vertebral bodies of the index level affected by any traumatic, neoplastic, metabolic, or infectious pathology. Subject has scoliosis of greater than 20 degrees (both angular and rotational). Grossly distorted anatomy due to congenital abnormalities. Deformation that affects the posterior corners of the vertebra at the index level (e.g., osteophytes) that, in the judgment of the surgeon, could affect the device implantation. Endplate irregularities that, in the judgment of the surgeon, could affect the device implantation. Prior surgery at the index lumbar vertebral level that, in the judgment of the surgeon, could affect the device implantation. Radiological confirmation of severe facet joint disease or degeneration. Patients diagnosed or at a high risk of osteoporosis (such as postmenopausal women and patients receiving long-term treatment with corticosteroids) who present a bone densitometry DXA (dual energy x-ray absorptiometry) T-score of less than -2.0 at the index level. Cauda equina syndrome. Fever, leucocytosis and/or systemic or localized active infection. Systemic inflammation and/or inflammation at the implantation site. Any uncontrolled metabolic bone disease that affects the spine. Uncontrolled insulin-dependent diabetes mellitus. Peripheral neuropathy. Active hepatitis, AIDS or HIV. Rheumatoid arthritis or other autoimmune disease that affects the spine joints. Active or history of any invasive malignancy; patients with curatively-treated malignancies who have been disease-free for at least 5 years are eligible. Uncontrolled active tuberculosis or history of uncontrolled tuberculosis in the past 3 years. Immunologically suppressed patients. Current anticoagulation therapy, unless anticoagulation therapy can be suspended for surgery. Patients who have received medication (e.g., methotrexate, alendronate) that interferes with bone mineral metabolism within 4 weeks of the planned date of the index surgery. Suspected or known allergies or intolerance to the device materials: titanium, nitinol, stainless steel, polyetheretherketone and polyethylene terephthalate. Any condition that precludes the use of general anaesthesia. Any condition that precludes the surgical procedure. Any contraindication for MRI or CT scan. Class III obesity: Body mass index ≥ 40. Current alcohol or recreational drug dependency. Pregnant or interested in becoming pregnant in the following 24 months. Breastfeeding. Life expectancy less than 2 years. Subject is currently participating or has participated in the previous 4 weeks in any other interventional clinical study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Laia Rofes, PhD
Phone
+34 935944726
Email
lrofes@neosurgery.com
First Name & Middle Initial & Last Name or Official Title & Degree
Daniel Alvarez, PhD
Phone
+34 935944726
Email
dalvarez@neosurgery.com
Facility Information:
Facility Name
Hospital Universitari de Bellvitge
City
Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08907
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Oscar Godino, MD, PhD
Facility Name
Hospital QuirónSalud Barcelona
City
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ignasi Català, MD
Phone
0034 932 554 083
Facility Name
Hospital Universitario de Canarias
City
La Laguna
Country
Spain
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hector Roldan, MD
Phone
0034 922 678 000
Facility Name
Hospital La Princesa
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
José Fernandez Alén, MD, PhD
Facility Name
Hospital General Universitario Gregorio Marañón
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carlos Fernandez, MD
Phone
+34 91 586 80 00
Facility Name
Hospital Universitario Fundación Jiménez Díaz
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Luis Alvarez, MD, PhD
Phone
+34 91 550 48 00
Facility Name
Hospital Universitario la Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Álvaro Gómez, MD
Phone
+34 917277000
Email
gomeznarro33@hotmail.com

12. IPD Sharing Statement

Learn more about this trial

Safety And Performance Of Disc Care To Prevent Lumbar Disc Herniation Recurrence

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