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Comparison of Unilateral or Bilateral Fixation in the Treatment of LFS

Primary Purpose

Lumbar Foraminal Stenosis

Status
Completed
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
TLIF and unilateral pedicle screw fixation
TLIF and bilateral pedicle screw fixation
Pedicle screw and cage
Sponsored by
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lumbar Foraminal Stenosis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Signed informed consent.
  • Patient is willing to be available for each examination scheduled over the study duration.
  • Lumbar foraminal stenosis diagnosed by patient history, physical examination and image confirmation.
  • Patient has symptoms referable to the stenosis level (low back pain, leg pain, tingling, numbness or weakness), which are relieved after a selective nerve root block.
  • Has not responded to conservative treatment for a period of 3 months (e.g. bed rest, physical therapy, medication, manipulations, other).

Exclusion Criteria:

  • Has systemic infection, highly communicable diseases, inflammatory or autoimmune disease (e.g. osteomyelitis, crohn's, rheumatoid arthritis, systemic lupus, gout, HIV/AIDS, active tuberculosis, venereal disease, active hepatitis).
  • Has presence of active malignancy
  • Has a history of severe allergy
  • Has a significant medical history that, in the investigator's opinion, would not make them a good study candidate.
  • Pregnant, or may become pregnant within follow-up period of study
  • Has other spinal conditions that will interfere with clinical outcomes (e.g. spinal structural deformities, spinal fractures, ankylosing spondylitis, spinal tuberculosis, spinal infection, spinal tumors, symptomatic cervical spinal disease)
  • Spondylolisthesis at the target level
  • Has undergone previous lumbar surgery
  • Has severe osteoporosis (T-score ≤ -3.5)
  • BMI > 35kg/m2
  • Has a diagnosis, which requires postoperative medication that interferes with fusion, such as steroids.
  • Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g. Paget's disease, renal osteodystrophy, Ehlers-Danios syndrome or osteogenesis imperfecta)

Sites / Locations

  • Department of Orthopedic Surgery, Shanghai Ninth People's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Unilateral fixation

Bilateral fixation

Arm Description

Patients undergoing TLIF and unilateral pedicle screw fixation

Patients undergoing TLIF and bilateral pedicle screw fixation

Outcomes

Primary Outcome Measures

Visual Analogue Scale (VAS) scores

Secondary Outcome Measures

Adverse events related to procedure
Operative duration
Estimated blood loss
Length of hospital stay
Spinal angles
Radiographic parameters
Intervertebral space height
Radiographic parameters
Foraminal height
Radiographic parameters
Cost of treatment
Fusion rate
Oswestry Disability Index (ODI)

Full Information

First Posted
November 23, 2016
Last Updated
January 8, 2022
Sponsor
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
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1. Study Identification

Unique Protocol Identification Number
NCT02985138
Brief Title
Comparison of Unilateral or Bilateral Fixation in the Treatment of LFS
Official Title
Comparison of Unilateral or Bilateral Fixation Using Pedicle Screws and TLIF in the Treatment of Lumbar Foraminal Stenosis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
December 2016 (Actual)
Primary Completion Date
September 2021 (Actual)
Study Completion Date
September 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University

4. Oversight

5. Study Description

Brief Summary
TLIF is a popular lumbar fusion technique to perform interbody fusion. Pedicle screws providing initial stability have been developed to correct deformity, improve the rate of fusion and speed patient's postoperative recovery. Conventionally, bilateral pedicle screw fixation is a standard approach. Recently, studies have revealed that unilateral pedicle screw fixation provides equivalent clinical outcomes and fusion rates as compared with bilateral pedicle screw fixation in lumbar fusion. Meanwhile, the unilateral approach can reduce intraoperative blood loss and operating time. To our knowledge, few randomized controlled studies comparing unilateral versus bilateral instrumented TLIF in lumbar degenerative diseases have been reported. The purpose of this study is to compare clinical and radiographic outcomes in a series of patients with lumbar foraminal stenosis using instrumented TLIF with unilateral or bilateral pedicle screw fixation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lumbar Foraminal Stenosis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Unilateral fixation
Arm Type
Experimental
Arm Description
Patients undergoing TLIF and unilateral pedicle screw fixation
Arm Title
Bilateral fixation
Arm Type
Active Comparator
Arm Description
Patients undergoing TLIF and bilateral pedicle screw fixation
Intervention Type
Procedure
Intervention Name(s)
TLIF and unilateral pedicle screw fixation
Intervention Description
TLIF combined with posterior unilateral pedicle screw fixation
Intervention Type
Procedure
Intervention Name(s)
TLIF and bilateral pedicle screw fixation
Intervention Description
TLIF combined with posterior bilateral pedicle screw fixation
Intervention Type
Device
Intervention Name(s)
Pedicle screw and cage
Intervention Description
Pedicle screw and cage
Primary Outcome Measure Information:
Title
Visual Analogue Scale (VAS) scores
Time Frame
2 years postoperatively
Secondary Outcome Measure Information:
Title
Adverse events related to procedure
Time Frame
2 years postoperatively
Title
Operative duration
Time Frame
1 week postoperatively
Title
Estimated blood loss
Time Frame
1 week postoperatively
Title
Length of hospital stay
Time Frame
1 week after discharge
Title
Spinal angles
Description
Radiographic parameters
Time Frame
2 years postoperatively
Title
Intervertebral space height
Description
Radiographic parameters
Time Frame
2 years postoperatively
Title
Foraminal height
Description
Radiographic parameters
Time Frame
2 years postoperatively
Title
Cost of treatment
Time Frame
2 years postoperatively
Title
Fusion rate
Time Frame
2 years postoperatively
Title
Oswestry Disability Index (ODI)
Time Frame
2 years postoperatively

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Signed informed consent. Patient is willing to be available for each examination scheduled over the study duration. Lumbar foraminal stenosis diagnosed by patient history, physical examination and image confirmation. Patient has symptoms referable to the stenosis level (low back pain, leg pain, tingling, numbness or weakness), which are relieved after a selective nerve root block. Has not responded to conservative treatment for a period of 3 months (e.g. bed rest, physical therapy, medication, manipulations, other). Exclusion Criteria: Has systemic infection, highly communicable diseases, inflammatory or autoimmune disease (e.g. osteomyelitis, crohn's, rheumatoid arthritis, systemic lupus, gout, HIV/AIDS, active tuberculosis, venereal disease, active hepatitis). Has presence of active malignancy Has a history of severe allergy Has a significant medical history that, in the investigator's opinion, would not make them a good study candidate. Pregnant, or may become pregnant within follow-up period of study Has other spinal conditions that will interfere with clinical outcomes (e.g. spinal structural deformities, spinal fractures, ankylosing spondylitis, spinal tuberculosis, spinal infection, spinal tumors, symptomatic cervical spinal disease) Spondylolisthesis at the target level Has undergone previous lumbar surgery Has severe osteoporosis (T-score ≤ -3.5) BMI > 35kg/m2 Has a diagnosis, which requires postoperative medication that interferes with fusion, such as steroids. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g. Paget's disease, renal osteodystrophy, Ehlers-Danios syndrome or osteogenesis imperfecta)
Facility Information:
Facility Name
Department of Orthopedic Surgery, Shanghai Ninth People's Hospital
City
Shanghai
ZIP/Postal Code
200011
Country
China

12. IPD Sharing Statement

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Comparison of Unilateral or Bilateral Fixation in the Treatment of LFS

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