Study of the Safety and Effectiveness of DIAM™ Spinal Stabilization System Versus Conservative Care

NCT ID: NCT00456378

Last Updated: 2018-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

311 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2018-11-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to establish the safety and effectiveness of the DIAM™ Spinal Stabilization System in the treatment of moderate single-level lumbar degenerative disc disease.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This pivotal clinical trial is being conducted to evaluate the DIAM™ Spinal Stabilization System for the treatment of single-level moderate lumbar degenerative disc disease. The implant under investigation in this clinical trial is the DIAM Spinal Stabilization System, and the device will be implanted using a posterior surgical approach. Patients in the control group will receive nonoperative treatment.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Lumbar Degenerative Disc Disease

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

DIAM™ spinal stabilization system

Implantation of the DIAM Spinal Stabilization System

Group Type EXPERIMENTAL

DIAM™ Spinal Stabilization System

Intervention Type DEVICE

Surgical procedure with implantation of the Investigational device

Conservative care

Conservative Care

Group Type ACTIVE_COMPARATOR

Conservative care

Intervention Type PROCEDURE

Six months of conservative care, to include: patient education, medications, physical therapy and spinal injections.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

DIAM™ Spinal Stabilization System

Surgical procedure with implantation of the Investigational device

Intervention Type DEVICE

Conservative care

Six months of conservative care, to include: patient education, medications, physical therapy and spinal injections.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Has moderate low back pain secondary to lumbar degenerative disc disease at a single level from L2 - L5. Low back pain is defined as persistent back pain, with or without radicular pain, with current episode of less than one year duration. Degenerative disc disease is confirmed by patient history, physical examination, and radiographic studies with one or more of the following factors (as measured radiographically by MRI scans or x-rays):

* Decreased disc height \>2mm, compared to the disc space at the next adjacent (superior or inferior, whichever has greater disc height) spinal level;
* Scarring/thickening of the ligamentum flavum, annulus fibrosis, or facet joint capsule;
* Herniated nucleus pulposus.
2. Is 18-70 years of age, inclusive, and is skeletally mature.
3. Has pre-treatment Oswestry score ≥ 30.
4. Has pre-treatment back pain score of ≥ 8 based on the Pre-Treatment Back and Leg Pain Questionnaire (Back Pain Intensity + Back Pain Frequency).
5. Has been treated nonoperatively (e.g. bed rest, physical therapy, medications, TENS, manipulation, and/or spinal injections) for a period of at least 6 weeks and not more than 6 months prior to enrollment in the clinical study.
6. If of child-bearing potential, patient is not pregnant or nursing and agrees not to become pregnant during the study period.
7. Is willing and able to participate in either of the randomized treatments for the duration of the study follow-up period. If the patient is randomized to the investigational group, he/she is willing to undergo surgery and receive the DIAM device. If the patient is randomized to the control group, he/she is willing to undergo all four nonoperative treatments.
8. Is willing and able to comply with the study plan and able to understand and sign the Patient Informed Consent Form.

Exclusion Criteria

A patient meeting any of the following criteria is to be excluded from this clinical trial:

1. Has disc height loss \> 67% at the involved level, compared to the next adjacent (superior or inferior, whichever has greater disc height) spinal level
2. Has Arachnoiditis.
3. Has a primary diagnosis of a spinal disorder other than degenerative disc disease at the involved level.
4. Requires treatment of degenerative disc disease at more than one lumbar level.
5. Has had all of the following nonoperative treatments (prescribed medications, active physical therapy, spinal injections, and patient education) within the past 6 weeks.
6. Has a sequestered herniated nucleus pulposus.
7. Has had any previous surgery at the involved or adjacent spinal levels (including procedures such as rhizotomy).
8. Has received any intradiskal ablation therapy, such as IDET.
9. Has congenital or iatrogenic posterior element insufficiency (e.g. facet resection, spondylolysis, pars fracture, or Spinal Bifida Occulta).
10. Has back pain (with or without leg, buttock, or groin pain) that is not alleviated in any spinal position.
11. Has a motor deficit of the lower extremity.
12. Has cauda equina syndrome.
13. Has compression of nerve roots with neurogenic bowel (fecal incontinence) or bladder (urinary retention or incontinence) dysfunction.
14. Has been previously diagnosed with clinically significant peripheral neuropathy.
15. Has significant vascular disease causing vascular claudication.
16. Has a medical contraindication that prevents the patient from receiving spinal injections (i.e., allergy to contrast media used to aid in placement of the needle in the epidural space).
17. Has ventral spondylolisthesis with more than 2 mm of translation at the involved level.
18. Has evidence of prior fracture or trauma to the L1, L2, L3, L4, or L5 levels in either compression or burst.
19. Has lumbar scoliosis with a Cobb angle of greater than 15°.
20. Has lumbar kyphosis or flat back syndrome.
21. Has sustained a hip fracture within the last year.
22. Has any of the following (if "Yes" to any of the below risk factors, a lumbar spine DEXA Scan will be required to determine eligibility.):

1. Previous diagnosis of osteoporosis, osteopenia, or osteomalacia.
2. Postmenopausal Non-Black female over 60 years of age who weighs less than 140 pounds.
3. Postmenopausal female who has sustained a non-traumatic hip, spine or wrist fracture.
4. Male over the age of 60 who has sustained a non-traumatic hip or spine fracture.

If the level of DEXA T-score is -1.0 or lower (i.e., -1.5, -2.0, etc.), the patient is excluded from the study.
23. Has obesity defined by BMI greater than or equal to 40. (Refer to the BMI Table provided in the CIP.)
24. Has a documented allergy to silicone, polyethylene, titanium, or latex.
25. Has overt or active bacterial infection, either local or systemic, and/or potential for bacteremia.
26. Has a suppressed immune system or has taken steroids at any dose daily for more than one month within the last year (excluding low dose inhalers for the treatment of asthma).
27. Has a history of autoimmune disease.
28. Has presence of active malignancy or prior history of malignancy within the last 5 years (except for basal cell carcinoma of the skin).
29. Has presence or prior history of a spinal malignancy.
30. Has chronic or acute renal and/or hepatic failure or prior history of renal and/or hepatic parenchymal disease.
31. Has any disease (e.g., neuromuscular disease) that would preclude accurate clinical evaluation of the safety and effectiveness of the treatment regimens in this study.
32. Has received treatment with an investigational therapy (device and/or pharmaceutical) within 30 days prior to entering the study or such treatment is planned during the 24 months following enrollment in the study.
33. Has an implantable metal device (e.g., stimulator, pacemaker) and is unable to have an MRI.
34. Is an alcohol and/or drug abuser, as defined by currently undergoing treatment for alcohol and/or drug abuse.
35. Is mentally incompetent. If questionable, obtain psychiatric consult.
36. Has a Waddell Signs of Inorganic Behavior score of 3 or greater.
37. Is a prisoner.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Medtronic Spinal and Biologics

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Spine Institute of Arizona

Scottsdale, Arizona, United States

Site Status

Tower Orthopaedic & Neurosurgical Spine Institute

Beverly Hills, California, United States

Site Status

Los Angeles Brain and Spine Institute

Los Angeles, California, United States

Site Status

Neurological Surgery

Mission Viejo, California, United States

Site Status

Loma Linda Orthopaedic Dept

San Bernardino, California, United States

Site Status

Boulder Neurosurgical Associates

Boulder, Colorado, United States

Site Status

George Washington University Medical Faculty Associates

Washington D.C., District of Columbia, United States

Site Status

Tallahassee Neurological Clinic

Tallahassee, Florida, United States

Site Status

Foundation for Orthopaedic Research and Education (FORE)

Tampa, Florida, United States

Site Status

Georgia Neurological Surgery

Athens, Georgia, United States

Site Status

Dr. Sokolowski

Oak Park, Illinois, United States

Site Status

Indiana Spine Group

Carmel, Indiana, United States

Site Status

Fort Wayne Orthopaedics

Fort Wayne, Indiana, United States

Site Status

OrthoIndy

Indianapolis, Indiana, United States

Site Status

Precision Spine and Orthopaedic Specialists

Overland Park, Kansas, United States

Site Status

Kansas Joint & Spine Institute

Wichita, Kansas, United States

Site Status

Sports Medicine North Orthopaedic Surgery, Inc.

Peabody, Massachusetts, United States

Site Status

University Physicians Group

Detroit, Michigan, United States

Site Status

Twin Cities Spine Center

Minneapolis, Minnesota, United States

Site Status

The Orthopedic Center of St. Louis

Chesterfield, Missouri, United States

Site Status

Advanced Neurosurgery Inc. / Kettering Medical Center

Kettering, Ohio, United States

Site Status

NeuroSpine Institute

Eugene, Oregon, United States

Site Status

Argires, Becker, Marotti, & Westphal Brain, Orthopedic/Sports Medicine & Spine Care

Lancaster, Pennsylvania, United States

Site Status

Orthopedic Institute

Sioux Falls, South Dakota, United States

Site Status

Spine Specialty Center

Memphis, Tennessee, United States

Site Status

Neurospine Surgical Consultants

Plano, Texas, United States

Site Status

Spine Team Texas

Southlake, Texas, United States

Site Status

The Smart Clinic

Sandy City, Utah, United States

Site Status

Department of Neurosurgery, University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

DIAM™ Device vs. Cons. Care

Identifier Type: -

Identifier Source: org_study_id