Safety and Efficacy of the ISS Sleeve Augmentation Technique in the Treatment of Thoracolumbar Osteopenic Fractures
Osteoporotic Fracture of Vertebra
About this trial
This is an interventional other trial for Osteoporotic Fracture of Vertebra focused on measuring bone augmentation, spine, pedicle screw, osteoporosis
Eligibility Criteria
Inclusion Criteria:
Patient
- Age ≥ 50 and ≤ 85, male and female patients
- Subject is able to understand the risks and benefits of participating in the study and is willing to provide written informed consent.
Psychosocially, mentally and physically able to fully comply with the protocol requirements for the duration of the study including adhering to scheduled visits, treatment plan, completing forms and other study procedures.
Fracture
- Fractures between the 10th thoracic and 4th lumbar vertebra, both included
- Bone mineral density equal or above the threshold of 60 mgHA/ccm (central assessment of the screening qCT scan).
- Fractures with the indication and possibility for augmented bi-segmental dorsal pedicle screw and rod stabilization including kyphoplasty in the broken vertebra
- All fractures where pedicle screws can be used
Exclusion Criteria:
Patient
- Substance use disorders (incl. tobacco abuse >20 cigarettes/day) and alcohol abuse disorders within the last 2 years before randomization.
- BMI > 35
- Permanent or progressive neurologic deficits (incl. upper motor neuron disease and myelopathy)
- Known Creutzfeldt Jacob Disease
Systemic infections:
- Known infection with human immunodeficiency virus (HIV) or, hepatitis B or C requiring treatment
- Any active infection requiring the use of parenteral anti-microbial agents or that is > grade 2 Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03
- Rheumatoid arthritis or known disorders of bone metabolism (excl. osteopenia/osteoporosis, Vitamin D deficiency)
- Radiation therapy of the spine in medical history
- Contraindications to pedicle screw and rod stabilization
- Breast feeding, pregnancy or child-bearing potential (female patients of childbearing potential and male patients with a partner of child bearing potential must agree to use a highly effective contraceptive method).
- A compromised immune system or a therapy with systemic corticosteroids or immunosuppressants
- Active malignancy or history of malignancy (excl. Basalioma as a semi-malignant tumor) <2 years ago from time of randomization
- Known allergy to any component of the investigational device
- History of severe allergy, anaphylactic reactions and hypersensitivity reactions experienced in previous surgical interventions.
- Other concurrent severe and/or uncontrolled medical conditions (e.g. insufficiently treated diabetes (HbA1c > 8 %), active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
Participation in other clinical investigations for drugs or devices
Fracture
- Fracture age > 3 months
- Major surgery to the spine planned for at least 12 months following enrolment
- Any treatment of the fracture other than that specified in the inclusion criteria (e.g. index screws in the fractured vertebra, vertebroplasty, additional ventral stabilization)
- Severe spinal deformations or fusion at the target vertebral or adjacent segments
- Previous operations at the spine in the target or adjacent vertebrae
- Infections or inflammatory processes at vertebral bodies
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Other
Other
Treatment with ISS Sleeve
Treatment with PMMA
The biocompatible, resorbable ISS sleeve is used for augmentation to enhance screw anchorage. It is melted into the trabecular bone structure of the osteoporotic vertebra using ultrasound. A standard pedicle screw is inserted into the sleeve.
The bone cement Polymethylmethacrylat (PMMA) that is injected into the osteoporotic vertebra.PMMA augmentation of pedicle screws is done using standard cannulated and perforated pedicle screws. The cancellous bone surrounding the screw is enhanced with PMMA bone cement to increase screw anchorage.