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Barricaid EU Post Market Study for Primary Lumbar Disc Herniation

Primary Purpose

Lumbar Disc Herniation

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Barricaid
Sponsored by
Intrinsic Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lumbar Disc Herniation focused on measuring Hernia, Intervertebral Disk Displacement, Pathological Conditions, Anatomical, Spinal Diseases, Bone Diseases, Musculoskeletal Diseases

Eligibility Criteria

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

Inclusion Criteria:

  1. Age 18 to 75 years old (male or female).
  2. Patients with posterior or posterolateral disc herniations at one or two levels between L1 and S1 with radiographic confirmation of neural compression using CT and/or MRI.
  3. At least six (6) 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.;
  4. Minimum posterior disc height of 3mm at the index level(s).
  5. Lower back pain and/or sciatica with or without spinal claudication.
  6. Oswestry Questionnaire score of at least 40/100 at baseline.
  7. VAS leg pain of at least 40/100 at baseline.

Exclusion Criteria:

  1. Spondylolisthesis Grade II or higher
  2. Subject requires uni or bilateral facetectomy to treat leg/back pain
  3. Subject has back or non-radicular leg pain of unknown etiology.
  4. Prior fusion (with or without instrumentation), motion preservation, facetectomy or IDET surgery at the index lumbar vertebral level
  5. Subject's requiring a spine DEXA (i.e., patients with SCORE of ≥ 6) with a T Score less than -2.0 at the index level.
  6. Subject has clinically compromised vertebral bodies at the index level(s) due to any traumatic, neoplastic, metabolic, or infectious pathology.
  7. Subject has sustained pathologic fractures of the vertebra or multiple fractures of the vertebra or hip.
  8. Subject has scoliosis of greater than ten (10) degrees (both angular and rotational).
  9. Any metabolic disease bone disease that has not been stabilized for at least three months (e.g., Paget's disease, osteomalacia, osteogenesis imperfecta, thyroid and/or parathyroid gland disorder, etc.).
  10. Subject has an active infection either systemic or local.
  11. Subject has cauda equine syndrome or neurogenic bowel/bladder dysfunction.
  12. Subject has severe arterial insufficiency of the legs (Screening on physical examination= patients with diminution or absence of dorsalis pedis or posterior tibialis pulses. If diminished or absent by palpation, then an arterial ultrasound is required with vascular plethysmography. If the absolute arterial pressure is below 50mm of Hg at the calf or ankle level, then the patient is to be excluded) or other peripheral vascular disease).
  13. Subject has significant peripheral neuropathy, patient defined as a patient with Type I or Type II diabetes or similar systemic metabolic condition causing decreased sensation in a stocking-like or non-radicular and non-dermatomal distribution in the lower extremities.
  14. Subject has insulin-dependent diabetes mellitus.
  15. Subject is morbidly obese (defined as a body mass index >40, or weighs more than 100 lbs over ideal body weight).
  16. Subject has been diagnosed with active hepatitis, AIDS, or HIV.
  17. Subject has been diagnosed with rheumatoid arthritis or other autoimmune disease.
  18. Subject has a known allergy to titanium, polyethylene or polyester materials.
  19. Subject is pregnant or interested in becoming pregnant in the next three (3) years.
  20. Subject has active tuberculosis or has had tuberculosis in the past three (3) years.
  21. Subject has a history of active malignancy: A patient with a history of any invasive malignancy (except non-melanoma skin cancer), unless he/she has been treated with curative intent and there have been no signs or symptoms of the malignancy for at least two (2) years.
  22. Subject is immunologically suppressed, received steroids >1 month over the past year.
  23. Currently taking anticoagulants, other than aspirin, unless the patient can be taken off the anticoagulant for surgery
  24. Subject has a current chemical/alcohol dependency or significant psychosocial disturbance.
  25. Subject has a life expectancy of less than three (3) years.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Barricaid

    Arm Description

    CE Marked Device

    Outcomes

    Primary Outcome Measures

    Patient function as measured on Oswestry Disability Index (ODI)
    15-point reduction in ODI at 24-month visit relative to baseline
    Disc height maintenance as measured from standing x-rays
    75% maintenance at 2 years relative to pre-op, measured by independent radiologist, (reference: Yorimitsu, et al, Spine 2001)
    Clinically symptomatic recurrent herniation at the index level, confirmed by imaging
    Performed at 24 months by the Investigator.
    Migration of the bone anchor posteriorly into the epidural space
    Radiographic imaging taken to ensure no migration of the device. Assessment made by the Investigator and Radiographic Core lab.
    Removal or revision of the implant
    Any removal or revision of the implant will be measured as a safety outcome.
    Supplemental fixation applied at the treated level
    Any supplemental fixation applied at the treated level will be tracked.

    Secondary Outcome Measures

    Back Pain on Visual Analog Scale (VAS)
    Back pain on VAS will be tracked.
    Leg Pain on Visual Analog Scale (VAS)
    Leg pain assessment will be tracked. Patient reported outcome.
    Quality of life on SF36
    Quality of life on SF36 will be tracked. Patient reported outcome.
    Comparison of neurological symptoms on clinical examination, relative to baseline
    Patient will have the following examinations: straight leg raising, deep tendon reflexes, forward bend, motor strength examination (hip flexors, knee extensors, tibialis, long toe extensors), and sensory (light touch, pin prick, or vibration)
    Frequency of AE's
    Frequency of AE's reported throughout the study will be tracked and analyzed at the 24 month visit.

    Full Information

    First Posted
    January 4, 2012
    Last Updated
    March 30, 2022
    Sponsor
    Intrinsic Therapeutics
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01534065
    Brief Title
    Barricaid EU Post Market Study for Primary Lumbar Disc Herniation
    Official Title
    A Multi-center, Post Marketing Surveillance Study to Monitor the Safety and Performance of the Barricaid® ARD in the Treatment of Back and Radicular Pain Caused by Primary Lumbar Disc Herniation
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2022
    Overall Recruitment Status
    Completed
    Study Start Date
    April 2009 (undefined)
    Primary Completion Date
    March 2013 (Actual)
    Study Completion Date
    March 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Intrinsic Therapeutics

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this multi-center post marketing surveillance study is to monitor the safety and performance of the Barricaid® ARD when used to surgically reconstruct the anulus of the L1 - S1 spinal disc.
    Detailed Description
    The purpose of this prospective, randomized, multicenter study is to demonstrate the superiority of the Barricaid® when used as an adjunct to a primary lumbar limited discectomy (as described by Spengler), to limited discectomy alone, with regard to preventing reherniation and the recurrence of pain or dysfunction. Patients, ages 21 - 75, will have, in part, a positive straight leg raise (or positive femoral stretch, as appropriate), MRI confirmation of a disc herniation, and minimum Oswestry and VAS leg scores of 40 out of 100 to qualify for this study. Additional patient criteria can be found in the inclusion/exclusion criteria section. Superiority of the Barricaid relative to limited discectomy alone will be based on a comparison of overall success rates of the Barricaid and a concurrent group (randomized) of control patients treated by primary lumbar limited discectomy at select European (approximately 15-20) sites. This study has two co-primary endpoints. Success of the study will be based on the Barricaid population achieving statistical superiority over the concurrently randomized non-implanted limited discectomy population at 2 years.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Lumbar Disc Herniation
    Keywords
    Hernia, Intervertebral Disk Displacement, Pathological Conditions, Anatomical, Spinal Diseases, Bone Diseases, Musculoskeletal Diseases

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Barricaid
    Arm Type
    Experimental
    Arm Description
    CE Marked Device
    Intervention Type
    Device
    Intervention Name(s)
    Barricaid
    Intervention Description
    Implanted intra-operatively during discectomy
    Primary Outcome Measure Information:
    Title
    Patient function as measured on Oswestry Disability Index (ODI)
    Description
    15-point reduction in ODI at 24-month visit relative to baseline
    Time Frame
    24 months
    Title
    Disc height maintenance as measured from standing x-rays
    Description
    75% maintenance at 2 years relative to pre-op, measured by independent radiologist, (reference: Yorimitsu, et al, Spine 2001)
    Time Frame
    24 months
    Title
    Clinically symptomatic recurrent herniation at the index level, confirmed by imaging
    Description
    Performed at 24 months by the Investigator.
    Time Frame
    24 months
    Title
    Migration of the bone anchor posteriorly into the epidural space
    Description
    Radiographic imaging taken to ensure no migration of the device. Assessment made by the Investigator and Radiographic Core lab.
    Time Frame
    24 months
    Title
    Removal or revision of the implant
    Description
    Any removal or revision of the implant will be measured as a safety outcome.
    Time Frame
    24 months
    Title
    Supplemental fixation applied at the treated level
    Description
    Any supplemental fixation applied at the treated level will be tracked.
    Time Frame
    24 months
    Secondary Outcome Measure Information:
    Title
    Back Pain on Visual Analog Scale (VAS)
    Description
    Back pain on VAS will be tracked.
    Time Frame
    24 months
    Title
    Leg Pain on Visual Analog Scale (VAS)
    Description
    Leg pain assessment will be tracked. Patient reported outcome.
    Time Frame
    24 months
    Title
    Quality of life on SF36
    Description
    Quality of life on SF36 will be tracked. Patient reported outcome.
    Time Frame
    24 months
    Title
    Comparison of neurological symptoms on clinical examination, relative to baseline
    Description
    Patient will have the following examinations: straight leg raising, deep tendon reflexes, forward bend, motor strength examination (hip flexors, knee extensors, tibialis, long toe extensors), and sensory (light touch, pin prick, or vibration)
    Time Frame
    24 months
    Title
    Frequency of AE's
    Description
    Frequency of AE's reported throughout the study will be tracked and analyzed at the 24 month visit.
    Time Frame
    24 months

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age 18 to 75 years old (male or female). Patients with posterior or posterolateral disc herniations at one or two levels between L1 and S1 with radiographic confirmation of neural compression using CT and/or MRI. At least six (6) 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 3mm at the index level(s). Lower back pain and/or sciatica with or without spinal claudication. Oswestry Questionnaire score of at least 40/100 at baseline. VAS leg pain of at least 40/100 at baseline. Exclusion Criteria: Spondylolisthesis Grade II or higher Subject requires uni or bilateral facetectomy to treat leg/back pain Subject has back or non-radicular leg pain of unknown etiology. Prior fusion (with or without instrumentation), motion preservation, facetectomy or IDET surgery at the index lumbar vertebral level Subject's requiring a spine DEXA (i.e., patients with SCORE of ≥ 6) with a T Score less than -2.0 at the index level. Subject has clinically compromised vertebral bodies at the index level(s) due to any traumatic, neoplastic, metabolic, or infectious pathology. Subject has sustained pathologic fractures of the vertebra or multiple fractures of the vertebra or hip. Subject has scoliosis of greater than ten (10) degrees (both angular and rotational). Any metabolic disease bone disease that has not been stabilized for at least three months (e.g., Paget's disease, osteomalacia, osteogenesis imperfecta, thyroid and/or parathyroid gland disorder, etc.). Subject has an active infection either systemic or local. Subject has cauda equine syndrome or neurogenic bowel/bladder dysfunction. Subject has severe arterial insufficiency of the legs (Screening on physical examination= patients with diminution or absence of dorsalis pedis or posterior tibialis pulses. If diminished or absent by palpation, then an arterial ultrasound is required with vascular plethysmography. If the absolute arterial pressure is below 50mm of Hg at the calf or ankle level, then the patient is to be excluded) or other peripheral vascular disease). Subject has significant peripheral neuropathy, patient defined as a patient with Type I or Type II diabetes or similar systemic metabolic condition causing decreased sensation in a stocking-like or non-radicular and non-dermatomal distribution in the lower extremities. Subject has insulin-dependent diabetes mellitus. Subject is morbidly obese (defined as a body mass index >40, or weighs more than 100 lbs over ideal body weight). Subject has been diagnosed with active hepatitis, AIDS, or HIV. Subject has been diagnosed with rheumatoid arthritis or other autoimmune disease. Subject has a known allergy to titanium, polyethylene or polyester materials. Subject is pregnant or interested in becoming pregnant in the next three (3) years. Subject has active tuberculosis or has had tuberculosis in the past three (3) years. Subject has a history of active malignancy: A patient with a history of any invasive malignancy (except non-melanoma skin cancer), unless he/she has been treated with curative intent and there have been no signs or symptoms of the malignancy for at least two (2) years. Subject is immunologically suppressed, received steroids >1 month over the past year. Currently taking anticoagulants, other than aspirin, unless the patient can be taken off the anticoagulant for surgery Subject has a current chemical/alcohol dependency or significant psychosocial disturbance. Subject has a life expectancy of less than three (3) years.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Claudius Thome, PhD
    Organizational Affiliation
    University of Innsbruck, Department of Neurosurgery
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    25983843
    Citation
    Lequin MB, Barth M, Thome C, Bouma GJ. Primary limited lumbar discectomy with an annulus closure device: one-year clinical and radiographic results from a prospective, multi-center study. Korean J Spine. 2012 Dec;9(4):340-7. doi: 10.14245/kjs.2012.9.4.340. Epub 2012 Dec 31.
    Results Reference
    result
    PubMed Identifier
    23377540
    Citation
    Bouma GJ, Barth M, Ledic D, Vilendecic M. The high-risk discectomy patient: prevention of reherniation in patients with large anular defects using an anular closure device. Eur Spine J. 2013 May;22(5):1030-6. doi: 10.1007/s00586-013-2656-1. Epub 2013 Feb 3.
    Results Reference
    result

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    Barricaid EU Post Market Study for Primary Lumbar Disc Herniation

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