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

NCT ID: NCT00389597

Last Updated: 2017-12-11

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

599 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2015-11-30

Brief Summary

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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

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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.

Conditions

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Degenerative Disc Disease

Keywords

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degenerative disc disease cervical arthroplasty Mobi C multilevel anterior cervical discectomy and fusion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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1 Level

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

Group Type EXPERIMENTAL

Cervical Artificial Disc

Intervention Type DEVICE

Cervical artificial disc mechanical device

2 Level

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

Group Type EXPERIMENTAL

Cervical Artificial Disc

Intervention Type DEVICE

Cervical artificial disc mechanical device

Interventions

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Cervical Artificial Disc

Cervical artificial disc mechanical device

Intervention Type DEVICE

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

69 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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LDR Spine USA

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ralph Rashbaum, MD

Role: PRINCIPAL_INVESTIGATOR

Texas Back Institute

Locations

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Texas Back Institute-West

Phoenix, Arizona, United States

Site Status

Southern California Institute of Neurological Surgery

Escondido, California, United States

Site Status

Massoudi & Jackson Neurosurgical Association

Laguna Hills, California, United States

Site Status

Memorial Orthopaedic Surgical Group

Long Beach, California, United States

Site Status

Eisenhower Medical Center

Rancho Mirage, California, United States

Site Status

University of California- Davis Medical Center

Sacramento, California, United States

Site Status

Spine Institute at St. John's Health Center

Santa Monica, California, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

Panorama Orthopedics and Spine Care

Golden, Colorado, United States

Site Status

Southeastern Clinical Research

Orlando, Florida, United States

Site Status

Orthopaedics North East

Fort Wayne, Indiana, United States

Site Status

Spine Institute of Louisiana

Shreveport, Louisiana, United States

Site Status

GBMC Healthcare

Baltimore, Maryland, United States

Site Status

University Neurologic Systems

Detroit, Michigan, United States

Site Status

St. Mary's of Saginaw Field Neurosciences Institute

Saginaw, Michigan, United States

Site Status

Simmons Orthopaedics and Spine Associates

Buffalo, New York, United States

Site Status

Orthopedic Spine Care of Long Island

Melville, New York, United States

Site Status

The Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Oklahoma Spine & Brain Institute

Tulsa, Oklahoma, United States

Site Status

Austin Brain and Spine

Austin, Texas, United States

Site Status

Foundation Surgical Hospital

Houston, Texas, United States

Site Status

West Texas Spine

Odessa, Texas, United States

Site Status

Texas Back Institute

Plano, Texas, United States

Site Status

Texas Spine and Joint Hospital

Tyler, Texas, United States

Site Status

Countries

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United States

References

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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.

Reference Type RESULT
PMID: 25694918 (View on PubMed)

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.

Reference Type RESULT
PMID: 24010901 (View on PubMed)

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.

Reference Type DERIVED
PMID: 29372135 (View on PubMed)

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.

Reference Type DERIVED
PMID: 27015130 (View on PubMed)

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.

Reference Type DERIVED
PMID: 26799118 (View on PubMed)

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.

Reference Type DERIVED
PMID: 25380538 (View on PubMed)

Related Links

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Other Identifiers

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LDR-001

Identifier Type: -

Identifier Source: org_study_id