Arthroplasty Versus Fusion in Anterior Cervical Surgery: Prospective Study of the Impact on the Adjacent Level

NCT ID: NCT00554528

Last Updated: 2015-09-30

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-05-31

Study Completion Date

2012-05-31

Brief Summary

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

The aim of the study is to evaluate the impact of the cervical disk surgery on the deterioration of the adjacent levels. The investigators compare the radiological deterioration of adjacent levels, at 3 years, in both situation of fusion and arthroplasty. 220 patients are enrolled and randomized to receive fusion or prosthesis. Radiological and clinical follow-up is organized for a period of 3 years.

Detailed Description

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

Anterior surgery of the cervical spine is one of the most practiced procedures in spine surgery. Its immediate accuracy and safety is proved since a long time in case of degenerative disk disease or disk herniation. But the segmental arthrodesis leads to an overload of the adjacent disk. A lot of studies have shown that the increasing mobility and pressure of the adjacent segments can be responsible of new degeneration and clinical symptoms. Recently, cervical disk prosthesis have been developed to maintain the mobility at the level of the surgery. This technique is supposed to decrease the risk of adjacent disk disease but, at this time, the analysis of the results is difficult, due to the lack of randomized studies with long term follow up.

The aim of our prospective randomized study is to evaluate the aftermath of the arthroplasty compared to the fusion on the adjacent disk degeneration.

The main objective is to show a radiological difference at 3 years in term of adjacent disk degeneration.

The secondary objectives are:

* evaluate the rate of new clinical symptoms during three years
* show differences during the postoperative period, especially concerning the length of the hospital stay, the use of pain killers and return to work.
* verify the maintaining of mobility pf the prosthesis during three years.

This is a controlled study with two group of equal size: one group is treated by discectomy and arthrodesis and the other by discectomy and prosthesis/ The criteria for the inclusion of the patients are: clinical radiculopathy and/or myelopathy due to a cervical disk disease (disk herniation or osteophytosis), lack of effect of the medical treatment, CT scan or MRI showing a compression of roots and/or spinal cord.

The main exclusion criteria are: plurisegmental disk disease, injuries happened during professional activities, previous cervical surgery.

During the study, we perform a clinical (standardized scales: Neck Disability Index, Short Form 36, and neurological exam) and a radiological (height of the adjacent disks, ostheophytis,…) follow-up.

The analysis of the current literature and statistical process leads to a total amount of 220 patients enrolled in the study. This is a multicentric study organized for a total duration of five years (two years for inclusions and three years of follow-up).

Conditions

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

Clinical Radiculopathy Myelopathy Due to a Cervical Disk 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

FACTORIAL

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.

A

patient receiving cervical disc prosthesis with a mobile insert named Mobi-C and product by LDR médical

Group Type OTHER

cervical disc prosthesis with a mobile insert named Mobi-C

Intervention Type DEVICE

Stage 1: partial discectomy

stage 2: location of the medial axis

stage 3: centering pin

stage 4: installation of the caspar spacer

stage 5: total discectomy

stage 6: parallel distraction

stage 7: depth measurement

stage 8: trial implant

stage 9: assembly

stage 10: implant insertion

stage 11: anchorage optimization

B

patient receiving intersomatic cage

Group Type OTHER

arthrodesis - cervical disk surgery

Intervention Type PROCEDURE

discectomy and arthrodesis

Interventions

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

cervical disc prosthesis with a mobile insert named Mobi-C

Stage 1: partial discectomy

stage 2: location of the medial axis

stage 3: centering pin

stage 4: installation of the caspar spacer

stage 5: total discectomy

stage 6: parallel distraction

stage 7: depth measurement

stage 8: trial implant

stage 9: assembly

stage 10: implant insertion

stage 11: anchorage optimization

Intervention Type DEVICE

arthrodesis - cervical disk surgery

discectomy and arthrodesis

Intervention Type PROCEDURE

Eligibility Criteria

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

Inclusion Criteria

* clinical radiculopathy
* myelopathy due to a cervical disk disease
* lack of effect of the medical treatment
* CT scan or MRI showing a compression of roots and/or spinal cord

Exclusion Criteria

* plurisegmenta disk disease
* injuries happened during professional activities
* previous cervical surgery
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

Centre Hospitalier Universitaire de Nice

OTHER

Sponsor Role lead

Responsible Party

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

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Stephane LITRICO, Dr

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier Universitaire de Nice

Locations

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

Department of Neurosurgery, CHU de Nice

Nice, , France

Site Status

Countries

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

France

References

Explore related publications, articles, or registry entries linked to this study.

Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine (Phila Pa 1976). 2005 May 15;30(10):1165-72. doi: 10.1097/01.brs.0000162441.23824.95.

Reference Type BACKGROUND
PMID: 15897831 (View on PubMed)

Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, An HS. Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine (Phila Pa 1976). 2002 Nov 15;27(22):2431-4. doi: 10.1097/00007632-200211150-00003.

Reference Type BACKGROUND
PMID: 12435970 (View on PubMed)

Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J. 2004 Nov-Dec;4(6 Suppl):190S-194S. doi: 10.1016/j.spinee.2004.07.007.

Reference Type BACKGROUND
PMID: 15541666 (View on PubMed)

Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, Van Calenbergh F, van Loon J. Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech. 2004 Apr;17(2):79-85. doi: 10.1097/00024720-200404000-00001.

Reference Type BACKGROUND
PMID: 15260088 (View on PubMed)

Link HD, McAfee PC, Pimenta L. Choosing a cervical disc replacement. Spine J. 2004 Nov-Dec;4(6 Suppl):294S-302S. doi: 10.1016/j.spinee.2004.07.022.

Reference Type BACKGROUND
PMID: 15541680 (View on PubMed)

Albert TJ, Eichenbaum MD. Goals of cervical disc replacement. Spine J. 2004 Nov-Dec;4(6 Suppl):292S-293S. doi: 10.1016/j.spinee.2004.07.023.

Reference Type BACKGROUND
PMID: 15541679 (View on PubMed)

McAfee PC. The indications for lumbar and cervical disc replacement. Spine J. 2004 Nov-Dec;4(6 Suppl):177S-181S. doi: 10.1016/j.spinee.2004.07.003.

Reference Type BACKGROUND
PMID: 15541664 (View on PubMed)

Fager CA. Cervical arthroplasty. J Neurosurg Spine. 2005 Mar;2(3):394-5; author reply 395. doi: 10.3171/spi.2005.2.3.0394. No abstract available.

Reference Type BACKGROUND
PMID: 15796370 (View on PubMed)

Phillips FM, Garfin SR. Cervical disc replacement. Spine (Phila Pa 1976). 2005 Sep 1;30(17 Suppl):S27-33. doi: 10.1097/01.brs.0000175192.55139.69.

Reference Type BACKGROUND
PMID: 16138062 (View on PubMed)

Pracyk JB, Traynelis VC. Treatment of the painful motion segment: cervical arthroplasty. Spine (Phila Pa 1976). 2005 Aug 15;30(16 Suppl):S23-32. doi: 10.1097/01.brs.0000174507.45083.98.

Reference Type BACKGROUND
PMID: 16103831 (View on PubMed)

Hacker RJ. Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005. J Neurosurg Spine. 2005 Dec;3(6):424-8. doi: 10.3171/spi.2005.3.6.0424.

Reference Type BACKGROUND
PMID: 16381203 (View on PubMed)

Robertson JT, Papadopoulos SM, Traynelis VC. Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine. 2005 Dec;3(6):417-23. doi: 10.3171/spi.2005.3.6.0417.

Reference Type BACKGROUND
PMID: 16381202 (View on PubMed)

Singh M, Gopinath R. Topical analgesia for chest tube removal in cardiac patients. J Cardiothorac Vasc Anesth. 2005 Dec;19(6):719-22. doi: 10.1053/j.jvca.2005.07.024.

Reference Type BACKGROUND
PMID: 16326294 (View on PubMed)

Chi JH, Ames CP, Tay B. General considerations for cervical arthroplasty with technique for ProDisc-C. Neurosurg Clin N Am. 2005 Oct;16(4):609-19, vi. doi: 10.1016/j.nec.2005.07.001.

Reference Type BACKGROUND
PMID: 16326284 (View on PubMed)

Bertagnoli R, Yue JJ, Pfeiffer F, Fenk-Mayer A, Lawrence JP, Kershaw T, Nanieva R. Early results after ProDisc-C cervical disc replacement. J Neurosurg Spine. 2005 Apr;2(4):403-10. doi: 10.3171/spi.2005.2.4.0403.

Reference Type BACKGROUND
PMID: 15871478 (View on PubMed)

Puttlitz CM, Rousseau MA, Xu Z, Hu S, Tay BK, Lotz JC. Intervertebral disc replacement maintains cervical spine kinetics. Spine (Phila Pa 1976). 2004 Dec 15;29(24):2809-14. doi: 10.1097/01.brs.0000147739.42354.a9.

Reference Type BACKGROUND
PMID: 15599283 (View on PubMed)

Puttlitz CM, DiAngelo DJ. Cervical spine arthroplasty biomechanics. Neurosurg Clin N Am. 2005 Oct;16(4):589-94, v. doi: 10.1016/j.nec.2005.07.002.

Reference Type BACKGROUND
PMID: 16326281 (View on PubMed)

Pickett GE, Rouleau JP, Duggal N. Kinematic analysis of the cervical spine following implantation of an artificial cervical disc. Spine (Phila Pa 1976). 2005 Sep 1;30(17):1949-54. doi: 10.1097/01.brs.0000176320.82079.ce.

Reference Type BACKGROUND
PMID: 16135984 (View on PubMed)

Parkinson JF, Sekhon LH. Cervical arthroplasty complicated by delayed spontaneous fusion. Case report. J Neurosurg Spine. 2005 Mar;2(3):377-80. doi: 10.3171/spi.2005.2.3.0377.

Reference Type BACKGROUND
PMID: 15796366 (View on PubMed)

Murray BE, Lopardo HA, Rubeglio EA, Frosolono M, Singh KV. Intrahospital spread of a single gentamicin-resistant, beta-lactamase-producing strain of Enterococcus faecalis in Argentina. Antimicrob Agents Chemother. 1992 Jan;36(1):230-2. doi: 10.1128/AAC.36.1.230.

Reference Type BACKGROUND
PMID: 1590694 (View on PubMed)

Bertagnoli R, Duggal N, Pickett GE, Wigfield CC, Gill SS, Karg A, Voigt S. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am. 2005 Jul;36(3):355-62. doi: 10.1016/j.ocl.2005.02.009.

Reference Type BACKGROUND
PMID: 15950695 (View on PubMed)

Pickett GE, Sekhon LH, Sears WR, Duggal N. Complications with cervical arthroplasty. J Neurosurg Spine. 2006 Feb;4(2):98-105. doi: 10.3171/spi.2006.4.2.98.

Reference Type BACKGROUND
PMID: 16506475 (View on PubMed)

Other Identifiers

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

06-APN-01

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Allogeinic Bone Paste
NCT04605120 UNKNOWN NA
Fusion Status After ACDF
NCT05986006 UNKNOWN NA
Cervical Spondylotic Myelopathy Surgical Trial
NCT02076113 ACTIVE_NOT_RECRUITING NA