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
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
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.
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
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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