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LDR Spine USA Mobi-C(R) Cervical Disc Prosthesis IDE

Primary Purpose

Degenerative Disc Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cervical Artificial Disc
Sponsored by
LDR Spine USA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Disc Disease focused on measuring degenerative disc disease, cervical arthroplasty, Mobi C, multilevel, anterior cervical discectomy and fusion

Eligibility Criteria

18 Years - 69 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18-69 years.
  2. Diagnosis of radiculopathy or myeloradiculopathy of the cervical spine, with pain, paresthesias or paralysis in a specific nerve root distribution C3 through C7, including at least one of the following:

    • Neck and/or arm pain (at least 30mm on the 100mm VAS scale).
    • Decreased muscle strength of at least one level on the clinical evaluation 0 to 5 scale.
    • Abnormal sensation including hyperesthesia or hypoesthesia; and/or
    • Abnormal reflexes
  3. Symptomatic at one or two adjacent levels from C3 to C7;
  4. Radiographically determined pathology at one or two adjacent level(s) to be treated correlating to primary symptoms including at least one of the following:

    • Decreased disc height on radiography, CT, or MRI in comparison to a normal adjacent disc.
    • Degenerative spondylosis on CT or MRI.
    • Disc herniation on CT or MRI;
  5. Neck Disability Index Score of ≥15/50 or ≥30%;
  6. Unresponsive to non-operative, conservative treatment (rest, heat, electrotherapy, physical therapy, chiropractic care and/or analgesics) for:

    • Approximately six weeks from radiculopathy or myeloradiculopathy symptom onset; or
    • Have the presence of progressive symptoms or signs of nerve root/spinal cord compression despite continued non-operative conservative treatment.

Note: Not a complete listing

Exclusion Criteria:

  1. Reported to have an active systemic infection or infection at the operative site;
  2. Reported to have a history of or anticipated treatment for active systemic infection, including HIV or Hepatitis C;
  3. More than one immobile vertebral level between C1 to C7 from any cause including but not limited to congenital abnormalities and osteoarthritic "spontaneous" fusions;
  4. Previous trauma to the C3 to C7 levels resulting in significant bony or disco-ligamentous cervical spine injury;
  5. Reported to have had any prior spine surgery at the operative level;
  6. Reported to have had prior cervical fusion procedure at any level;
  7. Axial neck pain in the absence of other symptoms of radiculopathy or myeloradiculopathy justifying the need for surgical intervention;
  8. Disc height less than 3mm as measured from the center of the disc in a neutral position and disc height less than 20% of the anterior-posterior width of the inferior vertebral body;
  9. Radiographic confirmation of severe facet joint disease or degeneration;

Note: Not a complete listing

Sites / Locations

  • Texas Back Institute-West
  • Southern California Institute of Neurological Surgery
  • Massoudi & Jackson Neurosurgical Association
  • Memorial Orthopaedic Surgical Group
  • Eisenhower Medical Center
  • University of California- Davis Medical Center
  • Spine Institute at St. John's Health Center
  • Stanford University
  • Panorama Orthopedics and Spine Care
  • Southeastern Clinical Research
  • Orthopaedics North East
  • Spine Institute of Louisiana
  • GBMC Healthcare
  • University Neurologic Systems
  • St. Mary's of Saginaw Field Neurosciences Institute
  • Simmons Orthopaedics and Spine Associates
  • Orthopedic Spine Care of Long Island
  • The Cleveland Clinic
  • Oklahoma Spine & Brain Institute
  • Austin Brain and Spine
  • Foundation Surgical Hospital
  • West Texas Spine
  • Texas Back Institute
  • Texas Spine and Joint Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

1 Level

2 Level

Arm Description

Cervical artificial disc (investigational device) at 1 level compared with control procedure (ACDF) at one level

Cervical artificial disc (investigational device) at 2 levels compared with control procedure (ACDF) at two levels

Outcomes

Primary Outcome Measures

Composite Definition of Study Success
An individual subject in either treatment group was considered a success if the following criteria were met at 24 months: Improvement in Neck Disability Index of at least 15/50 points in subjects with baseline Neck Disability Index scores of >= 30/50 points, or a 50% improvement in subjects with a baseline Neck Disability Score score of <30/50 where the Neck Disability Index is a measure designed to enable the physician to understand how much a subject's neck pain has affected his ability to manage everyday activities. No study failures due to secondary surgical interventions at the index level Absence of major complications defined as radiographic failure, neurologic failure, or failure by adverse event as adjudicated by the CEC

Secondary Outcome Measures

Full Information

First Posted
October 18, 2006
Last Updated
November 7, 2017
Sponsor
LDR Spine USA
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1. Study Identification

Unique Protocol Identification Number
NCT00389597
Brief Title
LDR Spine USA Mobi-C(R) Cervical Disc Prosthesis IDE
Official Title
LDR Spine USA Mobi-C(R) Cervical Disc Prosthesis IDE
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
April 2006 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
LDR Spine USA

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this investigation is to establish the safety and effectiveness of the LDR Spine Mobi-C® Cervical Disc Prosthesis which is an anterior cervical interbody mechanical device. The primary objective of the study is to evaluate the overall success rate of the investigational device as compared to the control in the treatment of patients with symptomatic DDD with radiculopathy or myeloradiculopathy at one or two adjacent levels. Patients should be without prior cervical fusion between C3 and C7 and unresponsive to non-operative conservative treatment for six weeks after symptom onset or have the presence of progressive symptoms or signs of nerve/spinal cord compression despite continued non-operative conservative treatment.
Detailed Description
Objectives of the Investigation The purpose of this investigation is to establish the safety and effectiveness of the LDR Spine Mobi-C® Cervical Disc Prosthesis which is an anterior cervical interbody mechanical device. The primary objective of the study is to evaluate the overall success rate of the investigational device as compared to the control in the treatment of patients with symptomatic DDD with radiculopathy or myeloradiculopathy at one or two adjacent levels. Patients should be without prior cervical fusion between C3 and C7 and unresponsive to non-operative conservative treatment for six weeks after symptom onset or have the presence of progressive symptoms or signs of nerve/spinal cord compression despite continued non-operative conservative treatment. Study Design Rationale The study is a prospective, randomized, multi-center, concurrently controlled investigation, in which the study device will be compared to the control treatment consisting of conventional anterior cervical discectomy and fusion (ACDF) in accordance with the Smith-Robinson procedure. Patients will be followed for two years postsurgery (primary endpoint) and at 3, 4, 5, and 7 years thereafter. Duration of the Investigation Patients will be followed post-operatively at 6 weeks, and 3-, 6-, 12-, 18-, and 24-months. After 24 months, patients will continue to be followed at 3,4, 5 and 7 years. Design Techniques to Avoid Bias To eliminate selection bias, investigational and control comparison groups will be assigned at random. Institutional Review Board No clinical studies will begin without documented approval of the clinical investigation by the Institutional Review Board (IRB) affiliated with the study center.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Disc Disease
Keywords
degenerative disc disease, cervical arthroplasty, Mobi C, multilevel, anterior cervical discectomy and fusion

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
599 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1 Level
Arm Type
Experimental
Arm Description
Cervical artificial disc (investigational device) at 1 level compared with control procedure (ACDF) at one level
Arm Title
2 Level
Arm Type
Experimental
Arm Description
Cervical artificial disc (investigational device) at 2 levels compared with control procedure (ACDF) at two levels
Intervention Type
Device
Intervention Name(s)
Cervical Artificial Disc
Intervention Description
Cervical artificial disc mechanical device
Primary Outcome Measure Information:
Title
Composite Definition of Study Success
Description
An individual subject in either treatment group was considered a success if the following criteria were met at 24 months: Improvement in Neck Disability Index of at least 15/50 points in subjects with baseline Neck Disability Index scores of >= 30/50 points, or a 50% improvement in subjects with a baseline Neck Disability Score score of <30/50 where the Neck Disability Index is a measure designed to enable the physician to understand how much a subject's neck pain has affected his ability to manage everyday activities. No study failures due to secondary surgical interventions at the index level Absence of major complications defined as radiographic failure, neurologic failure, or failure by adverse event as adjudicated by the CEC
Time Frame
2 Years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-69 years. Diagnosis of radiculopathy or myeloradiculopathy of the cervical spine, with pain, paresthesias or paralysis in a specific nerve root distribution C3 through C7, including at least one of the following: Neck and/or arm pain (at least 30mm on the 100mm VAS scale). Decreased muscle strength of at least one level on the clinical evaluation 0 to 5 scale. Abnormal sensation including hyperesthesia or hypoesthesia; and/or Abnormal reflexes Symptomatic at one or two adjacent levels from C3 to C7; Radiographically determined pathology at one or two adjacent level(s) to be treated correlating to primary symptoms including at least one of the following: Decreased disc height on radiography, CT, or MRI in comparison to a normal adjacent disc. Degenerative spondylosis on CT or MRI. Disc herniation on CT or MRI; Neck Disability Index Score of ≥15/50 or ≥30%; Unresponsive to non-operative, conservative treatment (rest, heat, electrotherapy, physical therapy, chiropractic care and/or analgesics) for: Approximately six weeks from radiculopathy or myeloradiculopathy symptom onset; or Have the presence of progressive symptoms or signs of nerve root/spinal cord compression despite continued non-operative conservative treatment. Note: Not a complete listing Exclusion Criteria: Reported to have an active systemic infection or infection at the operative site; Reported to have a history of or anticipated treatment for active systemic infection, including HIV or Hepatitis C; More than one immobile vertebral level between C1 to C7 from any cause including but not limited to congenital abnormalities and osteoarthritic "spontaneous" fusions; Previous trauma to the C3 to C7 levels resulting in significant bony or disco-ligamentous cervical spine injury; Reported to have had any prior spine surgery at the operative level; Reported to have had prior cervical fusion procedure at any level; Axial neck pain in the absence of other symptoms of radiculopathy or myeloradiculopathy justifying the need for surgical intervention; Disc height less than 3mm as measured from the center of the disc in a neutral position and disc height less than 20% of the anterior-posterior width of the inferior vertebral body; Radiographic confirmation of severe facet joint disease or degeneration; Note: Not a complete listing
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ralph Rashbaum, MD
Organizational Affiliation
Texas Back Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Texas Back Institute-West
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
Facility Name
Southern California Institute of Neurological Surgery
City
Escondido
State/Province
California
ZIP/Postal Code
92122
Country
United States
Facility Name
Massoudi & Jackson Neurosurgical Association
City
Laguna Hills
State/Province
California
ZIP/Postal Code
92653
Country
United States
Facility Name
Memorial Orthopaedic Surgical Group
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Eisenhower Medical Center
City
Rancho Mirage
State/Province
California
ZIP/Postal Code
92270
Country
United States
Facility Name
University of California- Davis Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Spine Institute at St. John's Health Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Panorama Orthopedics and Spine Care
City
Golden
State/Province
Colorado
ZIP/Postal Code
80401
Country
United States
Facility Name
Southeastern Clinical Research
City
Orlando
State/Province
Florida
ZIP/Postal Code
32804
Country
United States
Facility Name
Orthopaedics North East
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46825
Country
United States
Facility Name
Spine Institute of Louisiana
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Facility Name
GBMC Healthcare
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
University Neurologic Systems
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
St. Mary's of Saginaw Field Neurosciences Institute
City
Saginaw
State/Province
Michigan
ZIP/Postal Code
48604
Country
United States
Facility Name
Simmons Orthopaedics and Spine Associates
City
Buffalo
State/Province
New York
ZIP/Postal Code
14201
Country
United States
Facility Name
Orthopedic Spine Care of Long Island
City
Melville
State/Province
New York
ZIP/Postal Code
11747
Country
United States
Facility Name
The Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oklahoma Spine & Brain Institute
City
Tulsa
State/Province
Oklahoma
ZIP/Postal Code
74132
Country
United States
Facility Name
Austin Brain and Spine
City
Austin
State/Province
Texas
ZIP/Postal Code
78701
Country
United States
Facility Name
Foundation Surgical Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77401
Country
United States
Facility Name
West Texas Spine
City
Odessa
State/Province
Texas
ZIP/Postal Code
79761
Country
United States
Facility Name
Texas Back Institute
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Facility Name
Texas Spine and Joint Hospital
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25694918
Citation
Hisey MS, Bae HW, Davis R, Gaede S, Hoffman G, Kim K, Nunley PD, Peterson D, Rashbaum R, Stokes J. Multi-center, prospective, randomized, controlled investigational device exemption clinical trial comparing Mobi-C Cervical Artificial Disc to anterior discectomy and fusion in the treatment of symptomatic degenerative disc disease in the cervical spine. Int J Spine Surg. 2014 Dec 1;8:7. doi: 10.14444/1007. eCollection 2014.
Results Reference
result
PubMed Identifier
24010901
Citation
Davis RJ, Kim KD, Hisey MS, Hoffman GA, Bae HW, Gaede SE, Rashbaum RF, Nunley PD, Peterson DL, Stokes JK. Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial: clinical article. J Neurosurg Spine. 2013 Nov;19(5):532-45. doi: 10.3171/2013.6.SPINE12527. Epub 2013 Sep 6.
Results Reference
result
PubMed Identifier
29372135
Citation
Radcliff K, Davis RJ, Hisey MS, Nunley PD, Hoffman GA, Jackson RJ, Bae HW, Albert T, Coric D. Long-term Evaluation of Cervical Disc Arthroplasty with the Mobi-C(c) Cervical Disc: A Randomized, Prospective, Multicenter Clinical Trial with Seven-Year Follow-up. Int J Spine Surg. 2017 Nov 28;11(4):31. doi: 10.14444/4031. eCollection 2017.
Results Reference
derived
PubMed Identifier
27015130
Citation
Radcliff K, Coric D, Albert T. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial. J Neurosurg Spine. 2016 Aug;25(2):213-24. doi: 10.3171/2015.12.SPINE15824. Epub 2016 Mar 25. Erratum In: J Neurosurg Spine. 2016 Aug;25(2):280.
Results Reference
derived
PubMed Identifier
26799118
Citation
Jackson RJ, Davis RJ, Hoffman GA, Bae HW, Hisey MS, Kim KD, Gaede SE, Nunley PD. Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up. J Neurosurg Spine. 2016 May;24(5):734-45. doi: 10.3171/2015.8.SPINE15219. Epub 2016 Jan 22.
Results Reference
derived
PubMed Identifier
25380538
Citation
Davis RJ, Nunley PD, Kim KD, Hisey MS, Jackson RJ, Bae HW, Hoffman GA, Gaede SE, Danielson GO 3rd, Gordon C, Stone MB. Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results. J Neurosurg Spine. 2015 Jan;22(1):15-25. doi: 10.3171/2014.7.SPINE13953.
Results Reference
derived
Links:
URL
https://www.accessdata.fda.gov/cdrh_docs/pdf11/P110009A.pdf
Description
FDA Approval 2 Level
URL
https://www.accessdata.fda.gov/cdrh_docs/pdf11/P110002A.pdf
Description
FDA Approval 1 Level

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LDR Spine USA Mobi-C(R) Cervical Disc Prosthesis IDE

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