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PRESTIGE® Cervical Disc Study

Primary Purpose

Degenerative Cervical Disc Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Allograft Fusion and ATLANTIS™ Cervical Plate System
PRESTIGE® Cervical Disc
Sponsored by
Medtronic Spinal and Biologics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Cervical Disc Disease

Eligibility Criteria

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

Inclusion Criteria:

All patients participating in this study must meet all of the following inclusion criteria:

  1. Cervical degenerative disc disease defined as:

    intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression which is documented by patient history (e.g., neck and/or arm pain], functional deficit, and/or neurological deficit, and radiographic studies (e.g., CT, MRI, x-rays, etc).

    1. herniated disc;
    2. osteophyte formation;
  2. One cervical level requiring surgical treatment;
  3. C3-C4 disc to C6-C7 disc level of involvement;
  4. Unresponsive to non-operative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root/spinal cord compression in the face of continued non-operative management;
  5. No previous surgical intervention at the involved level or any subsequent, planned/staged surgical procedure at the involved or adjacent level(s);
  6. Is at least 18 years of age, inclusive, at the time of surgery;
  7. Preoperative Neck Disability Index score > or = 30;
  8. Has a preoperative neck pain score of > 20 based on the Preoperative Neck and Arm Pain Questionnaire.
  9. If of child-bearing potential, patient is not pregnant at the time of surgery;
  10. Is willing to comply with the study plan and sign the Patient Informed Consent Form.

Exclusion Criteria:

A patient meeting any of the following criteria is to be excluded from the study:

  1. Has a cervical spinal condition other than symptomatic cervical disc disease requiring surgical treatment at the involved level;
  2. Documented or diagnosed cervical instability defined by dynamic (flexion/extension) radiographs showing:

    1. Sagittal plane translation > 3.5 mm or;
    2. Sagittal plane angulation > 20.
  3. More than one cervical level requiring surgical treatment;
  4. Has a fused level adjacent to the level to be treated;
  5. Has severe pathology of the facet joints of the involved vertebral bodies;
  6. Previous surgical intervention at the involved level;
  7. Has been previously diagnosed with osteopenia or osteomalacia;
  8. Has any of the following that may be associated with a diagnosis of osteoporosis (if Yes to any of the below risk factors, a DEXA Scan will be required to determine eligibility):

    1. Postmenopausal Non-Black female over 60 years of age and weighs less than 140 pounds.
    2. Postmenopausal female that has sustained a non-traumatic hip, spine, or wrist fracture.
    3. Male over the age of 70.
    4. Male over the age of 60 that has sustained a non-traumatic hip or spine fracture.

    If the level of BMD is a T score of -3.5 or a T score of -2.5 with vertebral crush fracture, then the patient is excluded from the study.

  9. Has presence of spinal metastases;
  10. Has overt or active bacterial infection, either local or systemic;
  11. Has severe insulin dependent diabetes;
  12. Has chronic or acute renal failure or prior history of renal disease;
  13. Has fever (temperature > 101 F oral) at the time of surgery;
  14. Has a documented allergy or intolerance to stainless steel, titanium, or a titanium alloy;
  15. Is mentally incompetent. (If questionable, obtain psychiatric consult);
  16. Is a prisoner;
  17. Is pregnant;
  18. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug abuse;
  19. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs;
  20. Has a history of an endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's Disease, renal osteodystrophy, Ehlers-Danlos Syndrome, or osteogenesis imperfecta);
  21. Has a condition that requires postoperative medications that interfere with the stability of the implant or fusion, such as steroids. (This does not include low dose aspirin for prophylactic anticoagulation and routine perioperative anti-inflammatory drugs);
  22. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the16 weeks following Artificial Cervical Disc implantation.

Sites / Locations

  • North Alabama Neurological
  • Montgomery Neurosurgical
  • University of California, Davis
  • The Spine Institute
  • Orlando Neurosurgery
  • Atlanta Brain and Spine Care
  • Emory Orthop and Spine Center
  • Hughston Clinic
  • Central Illinois Neuroscience
  • Loyola University Medical Center
  • Orthoindy
  • University of Iowa Hospitals and Clinics
  • Baton Rouge Orth Clinic
  • Neurosurgery Ass, P.A.
  • Michigan Brain & Spine Institute
  • The Ortho Center of St. Louis
  • Springfield Neurological Institute
  • Surgical Neurology New Hampshire Neurospine Institute
  • Buffalo Neurosurgery Group
  • Oregon Health & Science University
  • Westphal Group
  • Center of Neurosciences Orthopedics & Spine, P.C.
  • Spine Surgery Associates
  • Semmes Murphey
  • Howell Allen Clinic
  • Brain and Spine Center of Texas
  • Neurosugical Associates, PC
  • Inland Neurosurgery & Spine Associates, P.S.
  • University of Wisconsin Medical School
  • Central Wyoming Neurosurgery
  • Wyoming Brain and Spine Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Control

Investigational

Arm Description

The Control cohort are patients that receive the fusion treatment.

The Investigational cohort are the study patients that received the PRESTIGE® Cervical Disc.

Outcomes

Primary Outcome Measures

The primary endpoint is overall success, which consists of NDI score, neuro status success, with/without FSU disc ht success, no serious AE classified as "implant/surgical procedure associated", and no secondary surgical procedure classified as failure

Secondary Outcome Measures

The secondary outcomes are radiographic success, medical outcomes SF-36 patient survey (MCS & PCS) success, neck pain status, arm pain status, patient satisfaction, patient global perceived effect, gait assessment, foraminal compression test

Full Information

First Posted
March 19, 2008
Last Updated
May 9, 2023
Sponsor
Medtronic Spinal and Biologics
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1. Study Identification

Unique Protocol Identification Number
NCT00642876
Brief Title
PRESTIGE® Cervical Disc Study
Official Title
Investigation of the PRESTIGE® Cervical Disc Device at a Single Level for Symptomatic Cervical Disc Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
July 2006 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Spinal and Biologics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this clinical investigation is to evaluate the safety and effectiveness of the ACD in the single level surgical treatment of patients with symptomatic cervical degenerative disc disease. The primary follow-up information obtained from this clinical investigation are used to support a PMA application for the ACD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Cervical Disc Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Control
Arm Type
Active Comparator
Arm Description
The Control cohort are patients that receive the fusion treatment.
Arm Title
Investigational
Arm Type
Experimental
Arm Description
The Investigational cohort are the study patients that received the PRESTIGE® Cervical Disc.
Intervention Type
Device
Intervention Name(s)
Allograft Fusion and ATLANTIS™ Cervical Plate System
Other Intervention Name(s)
ATLANTIS™
Intervention Description
The patients that received the control treatment underwent a single level anterior cervical fusion procedure involving allograft bone and the ATLANTIS™ Cervical Plate System.
Intervention Type
Device
Intervention Name(s)
PRESTIGE® Cervical Disc
Other Intervention Name(s)
PRESTIGE®
Intervention Description
The PRESTIGE® Cervical Disc is a stainless steel device that was inserted into the intervertebral disc space. The device is composed of two metal plates that interface via a ball and socket mechanism permitting segmental spinal motion.
Primary Outcome Measure Information:
Title
The primary endpoint is overall success, which consists of NDI score, neuro status success, with/without FSU disc ht success, no serious AE classified as "implant/surgical procedure associated", and no secondary surgical procedure classified as failure
Time Frame
24 months
Secondary Outcome Measure Information:
Title
The secondary outcomes are radiographic success, medical outcomes SF-36 patient survey (MCS & PCS) success, neck pain status, arm pain status, patient satisfaction, patient global perceived effect, gait assessment, foraminal compression test
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All patients participating in this study must meet all of the following inclusion criteria: Cervical degenerative disc disease defined as: intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression which is documented by patient history (e.g., neck and/or arm pain], functional deficit, and/or neurological deficit, and radiographic studies (e.g., CT, MRI, x-rays, etc). herniated disc; osteophyte formation; One cervical level requiring surgical treatment; C3-C4 disc to C6-C7 disc level of involvement; Unresponsive to non-operative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root/spinal cord compression in the face of continued non-operative management; No previous surgical intervention at the involved level or any subsequent, planned/staged surgical procedure at the involved or adjacent level(s); Is at least 18 years of age, inclusive, at the time of surgery; Preoperative Neck Disability Index score > or = 30; Has a preoperative neck pain score of > 20 based on the Preoperative Neck and Arm Pain Questionnaire. If of child-bearing potential, patient is not pregnant at the time of surgery; Is willing to comply with the study plan and sign the Patient Informed Consent Form. Exclusion Criteria: A patient meeting any of the following criteria is to be excluded from the study: Has a cervical spinal condition other than symptomatic cervical disc disease requiring surgical treatment at the involved level; Documented or diagnosed cervical instability defined by dynamic (flexion/extension) radiographs showing: Sagittal plane translation > 3.5 mm or; Sagittal plane angulation > 20. More than one cervical level requiring surgical treatment; Has a fused level adjacent to the level to be treated; Has severe pathology of the facet joints of the involved vertebral bodies; Previous surgical intervention at the involved level; Has been previously diagnosed with osteopenia or osteomalacia; Has any of the following that may be associated with a diagnosis of osteoporosis (if Yes to any of the below risk factors, a DEXA Scan will be required to determine eligibility): Postmenopausal Non-Black female over 60 years of age and weighs less than 140 pounds. Postmenopausal female that has sustained a non-traumatic hip, spine, or wrist fracture. Male over the age of 70. Male over the age of 60 that has sustained a non-traumatic hip or spine fracture. If the level of BMD is a T score of -3.5 or a T score of -2.5 with vertebral crush fracture, then the patient is excluded from the study. Has presence of spinal metastases; Has overt or active bacterial infection, either local or systemic; Has severe insulin dependent diabetes; Has chronic or acute renal failure or prior history of renal disease; Has fever (temperature > 101 F oral) at the time of surgery; Has a documented allergy or intolerance to stainless steel, titanium, or a titanium alloy; Is mentally incompetent. (If questionable, obtain psychiatric consult); Is a prisoner; Is pregnant; Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug abuse; Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs; Has a history of an endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's Disease, renal osteodystrophy, Ehlers-Danlos Syndrome, or osteogenesis imperfecta); Has a condition that requires postoperative medications that interfere with the stability of the implant or fusion, such as steroids. (This does not include low dose aspirin for prophylactic anticoagulation and routine perioperative anti-inflammatory drugs); Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the16 weeks following Artificial Cervical Disc implantation.
Facility Information:
Facility Name
North Alabama Neurological
City
Huntsville
State/Province
Alabama
ZIP/Postal Code
35801
Country
United States
Facility Name
Montgomery Neurosurgical
City
Montgomery
State/Province
Alabama
ZIP/Postal Code
36106
Country
United States
Facility Name
University of California, Davis
City
Sacramento
State/Province
California
ZIP/Postal Code
95816
Country
United States
Facility Name
The Spine Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States
Facility Name
Orlando Neurosurgery
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
Facility Name
Atlanta Brain and Spine Care
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Emory Orthop and Spine Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Hughston Clinic
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31908
Country
United States
Facility Name
Central Illinois Neuroscience
City
Bloomington
State/Province
Illinois
ZIP/Postal Code
61701
Country
United States
Facility Name
Loyola University Medical Center
City
Oak Park
State/Province
Illinois
ZIP/Postal Code
60302
Country
United States
Facility Name
Orthoindy
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46278
Country
United States
Facility Name
University of Iowa Hospitals and Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Baton Rouge Orth Clinic
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70810
Country
United States
Facility Name
Neurosurgery Ass, P.A.
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21237
Country
United States
Facility Name
Michigan Brain & Spine Institute
City
Ypsilanti
State/Province
Michigan
ZIP/Postal Code
48197
Country
United States
Facility Name
The Ortho Center of St. Louis
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
Springfield Neurological Institute
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807
Country
United States
Facility Name
Surgical Neurology New Hampshire Neurospine Institute
City
Bedford
State/Province
New Hampshire
ZIP/Postal Code
03110
Country
United States
Facility Name
Buffalo Neurosurgery Group
City
West Seneca
State/Province
New York
ZIP/Postal Code
14224
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97201
Country
United States
Facility Name
Westphal Group
City
Lancaster
State/Province
Pennsylvania
ZIP/Postal Code
17601
Country
United States
Facility Name
Center of Neurosciences Orthopedics & Spine, P.C.
City
Dakota Dunes
State/Province
South Dakota
ZIP/Postal Code
57049
Country
United States
Facility Name
Spine Surgery Associates
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37421
Country
United States
Facility Name
Semmes Murphey
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38104
Country
United States
Facility Name
Howell Allen Clinic
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Brain and Spine Center of Texas
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Facility Name
Neurosugical Associates, PC
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23229
Country
United States
Facility Name
Inland Neurosurgery & Spine Associates, P.S.
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States
Facility Name
University of Wisconsin Medical School
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Facility Name
Central Wyoming Neurosurgery
City
Casper
State/Province
Wyoming
ZIP/Postal Code
82601
Country
United States
Facility Name
Wyoming Brain and Spine Institute
City
Casper
State/Province
Wyoming
ZIP/Postal Code
82601
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
20809722
Citation
Burkus JK, Haid RW, Traynelis VC, Mummaneni PV. Long-term clinical and radiographic outcomes of cervical disc replacement with the Prestige disc: results from a prospective randomized controlled clinical trial. J Neurosurg Spine. 2010 Sep;13(3):308-18. doi: 10.3171/2010.3.SPINE09513.
Results Reference
background
PubMed Identifier
17355018
Citation
Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine. 2007 Mar;6(3):198-209. doi: 10.3171/spi.2007.6.3.198.
Results Reference
background
PubMed Identifier
31970051
Citation
Gornet MF, Lanman TH, Burkus JK, Hodges SD, McConnell JR, Dryer RF, Schranck FW, Copay AG. One-Level Versus 2-Level Treatment With Cervical Disc Arthroplasty or Fusion: Outcomes Up to 7 Years. Int J Spine Surg. 2019 Dec 31;13(6):551-560. doi: 10.14444/6076. eCollection 2019 Dec.
Results Reference
derived
PubMed Identifier
27129045
Citation
Arnold PM, Anderson KK, Selim A, Dryer RF, Kenneth Burkus J. Heterotopic ossification following single-level anterior cervical discectomy and fusion: results from the prospective, multicenter, historically controlled trial comparing allograft to an optimized dose of rhBMP-2. J Neurosurg Spine. 2016 Sep;25(3):292-302. doi: 10.3171/2016.1.SPINE15798. Epub 2016 Apr 29.
Results Reference
derived
PubMed Identifier
25036218
Citation
Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV. Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: Clinical article. J Neurosurg Spine. 2014 Oct;21(4):516-28. doi: 10.3171/2014.6.SPINE13996. Epub 2014 Jul 18.
Results Reference
derived

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PRESTIGE® Cervical Disc Study

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