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Assessment of nanOss Bioactive 3D in the Posterolateral Spine

Primary Purpose

Degenerative Disc Disease, Spinal Stenosis, Spondylolisthesis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
nanOss Bioactive 3D BVF
Sponsored by
Pioneer Surgical Technology, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Disc Disease

Eligibility Criteria

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

Inclusion Criteria:

  • At least 21 years of age and skeletally mature.
  • Symptomatic spinal stenosis secondary to DDD with up to Grade 1 spondylolisthesis at one or two adjacent levels from L2-S1 requiring instrumented PLF surgery.
  • Completed a minimum of 6 months of non-operative treatment.
  • Pre-operative objective evidence of primary diagnosis confirmed by appropriate imaging studies (AP, Lateral, Flexion and Extension images and an MRI or CT scan).
  • Is willing and able to return for post-treatment exams according to the follow-up called for in the protocol.
  • Is able to review, understand and sign the informed consent document.

Exclusion Criteria:

  • Symptomatic at more than two levels.
  • Has had previous fusion surgery at the level(s) to be treated (previous discectomy, laminotomy, laminectomy or nucleolysis at the level(s) to be treated < 6 months ago is ok).
  • Has > 11 degrees lumbar scoliosis.
  • Has > 40 BMI.
  • Has > Grade 1 spondylolisthesis.
  • Has osteoporosis (T-score of -2.5 or below), osteomalacia, Paget's disease or metabolic bone disease.
  • Has a disease that significantly inhibits bone healing (e.g., diabetes type 1, renal failure, impaired calcium metabolism).
  • Has a medical condition that requires or has a history of chronic steroid use (i.e., oral steroids), with the exception of inhaled/nasal corticosteroids steroids or has any medical condition that requires treatment with drugs known to interfere with bone healing.
  • Has a neurological disease (e.g., Parkinson's disease), a psychosocial disorder (e.g., suicidal, diminished capacity) or has a history of substance abuse which would preclude accurate evaluation or limit the ability to comply with study requirements.
  • Has either an active infection or infection at the site of surgery
  • Has a systemic disease (e.g., AIDS, HIV, active hepatitis, tuberculosis)
  • Has rheumatoid arthritis or other autoimmune disease.
  • Has spinal tumors.
  • Has an active malignancy (except non-melanoma skin cancer) or history of any invasive malignancy unless treated and in remission for at least five years.
  • Has a known sensitivity or allergies to porcine collagen, PEEK, tantalum or titanium.
  • Has active arachnoiditis.
  • Has fractures of the epiphyseal plate or fractures for which stabilization of the fracture is not possible.
  • Is a prisoner.
  • Is involved in spinal litigation at the treated level(s).
  • Is participating in another clinical study that would confound Study data.
  • Is pregnant or is interested in becoming pregnant while participating in the Study.

Sites / Locations

  • Hospital for Joint Disease
  • Hospital for Special Surgery
  • MUSC Neurosurgery & Spine Services
  • Milwaukee Spinal Specialists

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

nanOss Bioactive 3D BVF

Arm Description

Bilateral, instrumented posterolateral fusion surgery where nanOss Bioactive 3D will be hydrated with autologous BMA and placed bilaterally on a bed of local autograft bone spanning the transverse processes of the treated segment. If an interbody fusion is performed, only a PLIF or TLIF with PEEK IBF devices may be performed.

Outcomes

Primary Outcome Measures

Number of Patients With Fusion
Fusion is defined as the presence of bridging trabecular bone and less than 3mm of translational motion and less than 5mm of angular motion.

Secondary Outcome Measures

Number of Participants With Improvement in Quality of Life
Number of participants with improvement in quality of life after surgery using the RAND-36 (a short form health survey). It is a 36 set of easily administered quality of life measures answered by the patient.
Number of Participants With Improvement in Pain Scores
Number of participants with improvement in pain scores after surgery using the Visual Analog Scale. The scale measured from (0) no pain to (10) unbearable pain.
Number of Participants With Decreased Usage of Pain Medication
Number of participants with decreased usage of pain medication after surgery
Returning to Work
Time frame in which patient returned to work after surgery
Satisfaction With Surgery
Overall satisfaction with the procedure

Full Information

First Posted
April 8, 2013
Last Updated
March 27, 2019
Sponsor
Pioneer Surgical Technology, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01829997
Brief Title
Assessment of nanOss Bioactive 3D in the Posterolateral Spine
Official Title
A Prospective, Post-Market Assessment Of NanOss Bioactive 3D in the Posterolateral Spine
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
April 2013 (undefined)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pioneer Surgical Technology, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Spine fusion is one of the most common procedures performed in spinal surgery. Several surgical techniques can achieve a solid union, but the intertransverse posterolateral fusion (PLF) is the most widely used. However, complications can develop when the bone graft material used is insufficient to achieve the desired fusion. With its unique properties, nanOss Bioactive 3D can be mixed with bone marrow aspirate (BMA) and autograft bone to obtain new bone growth during the healing process. nanOss Bioactive 3D is approved for use in the U.S., however, additional information is useful to assess its efficacy in the posterolateral spine. The purpose of this study is to assess fusion results in the posterolateral spine using nanOss Bioactive 3D mixed with autograft bone and BMA. It is hypothesized that the use of nanOss Bioactive 3D will result in fusion at 12 months, with CT evidence of bridging trabecular bone, less than 3mm of translational motion, and less than 5 degrees of angular motion.
Detailed Description
The post market clinical investigation is designed to assess instrumented PLF using nanOss Bioactive 3D bone void filler with autograft bone and bone marrow aspirate in patients with symptomatic spinal stenosis secondary to degenerative disc disease (DDD) with up to Grade 1 spondylolisthesis at one or two adjacent levels from L2-S1 characterized by the inclusion and exclusion criteria. Patients will be evaluated at Preop, discharge, 6 and 12 months. X-rays will be obtained at each visit; Additionally, a CT scan will be performed at the 12 month postoperative visit to assess fusion status.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Disc Disease, Spinal Stenosis, Spondylolisthesis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
nanOss Bioactive 3D BVF
Arm Type
Experimental
Arm Description
Bilateral, instrumented posterolateral fusion surgery where nanOss Bioactive 3D will be hydrated with autologous BMA and placed bilaterally on a bed of local autograft bone spanning the transverse processes of the treated segment. If an interbody fusion is performed, only a PLIF or TLIF with PEEK IBF devices may be performed.
Intervention Type
Device
Intervention Name(s)
nanOss Bioactive 3D BVF
Intervention Description
nanOss Bioactive 3D BVF, combined with autograft and bone marrow aspirate, used in the posterolateral spine between L2 and S1. Instrumentation is required. Interbody fusion with PEEK device and autograft may or may not be performed.
Primary Outcome Measure Information:
Title
Number of Patients With Fusion
Description
Fusion is defined as the presence of bridging trabecular bone and less than 3mm of translational motion and less than 5mm of angular motion.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Number of Participants With Improvement in Quality of Life
Description
Number of participants with improvement in quality of life after surgery using the RAND-36 (a short form health survey). It is a 36 set of easily administered quality of life measures answered by the patient.
Time Frame
12 months
Title
Number of Participants With Improvement in Pain Scores
Description
Number of participants with improvement in pain scores after surgery using the Visual Analog Scale. The scale measured from (0) no pain to (10) unbearable pain.
Time Frame
12 months
Title
Number of Participants With Decreased Usage of Pain Medication
Description
Number of participants with decreased usage of pain medication after surgery
Time Frame
12 months
Title
Returning to Work
Description
Time frame in which patient returned to work after surgery
Time Frame
12 Months
Title
Satisfaction With Surgery
Description
Overall satisfaction with the procedure
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At least 21 years of age and skeletally mature. Symptomatic spinal stenosis secondary to DDD with up to Grade 1 spondylolisthesis at one or two adjacent levels from L2-S1 requiring instrumented PLF surgery. Completed a minimum of 6 months of non-operative treatment. Pre-operative objective evidence of primary diagnosis confirmed by appropriate imaging studies (AP, Lateral, Flexion and Extension images and an MRI or CT scan). Is willing and able to return for post-treatment exams according to the follow-up called for in the protocol. Is able to review, understand and sign the informed consent document. Exclusion Criteria: Symptomatic at more than two levels. Has had previous fusion surgery at the level(s) to be treated (previous discectomy, laminotomy, laminectomy or nucleolysis at the level(s) to be treated < 6 months ago is ok). Has > 11 degrees lumbar scoliosis. Has > 40 BMI. Has > Grade 1 spondylolisthesis. Has osteoporosis (T-score of -2.5 or below), osteomalacia, Paget's disease or metabolic bone disease. Has a disease that significantly inhibits bone healing (e.g., diabetes type 1, renal failure, impaired calcium metabolism). Has a medical condition that requires or has a history of chronic steroid use (i.e., oral steroids), with the exception of inhaled/nasal corticosteroids steroids or has any medical condition that requires treatment with drugs known to interfere with bone healing. Has a neurological disease (e.g., Parkinson's disease), a psychosocial disorder (e.g., suicidal, diminished capacity) or has a history of substance abuse which would preclude accurate evaluation or limit the ability to comply with study requirements. Has either an active infection or infection at the site of surgery Has a systemic disease (e.g., AIDS, HIV, active hepatitis, tuberculosis) Has rheumatoid arthritis or other autoimmune disease. Has spinal tumors. Has an active malignancy (except non-melanoma skin cancer) or history of any invasive malignancy unless treated and in remission for at least five years. Has a known sensitivity or allergies to porcine collagen, PEEK, tantalum or titanium. Has active arachnoiditis. Has fractures of the epiphyseal plate or fractures for which stabilization of the fracture is not possible. Is a prisoner. Is involved in spinal litigation at the treated level(s). Is participating in another clinical study that would confound Study data. Is pregnant or is interested in becoming pregnant while participating in the Study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen Robbins, MD
Organizational Affiliation
Milwaukee Spinal Specialists
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital for Joint Disease
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
Hospital for Special Surgery
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
MUSC Neurosurgery & Spine Services
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Milwaukee Spinal Specialists
City
Glendale
State/Province
Wisconsin
ZIP/Postal Code
53212
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Assessment of nanOss Bioactive 3D in the Posterolateral Spine

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