Physical Capability Outcomes After Single-Level PD-L vs Single-Level ALIF: a Multi-Center Clinical Trial

NCT ID: NCT01055574

Last Updated: 2011-09-09

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

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Recruitment Status

TERMINATED

Total Enrollment

45 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-10-31

Study Completion Date

2012-01-31

Brief Summary

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The purpose of this study is to compare the physical capability outcomes of patients who undergo single-level ProDisc-L disc replacement with those of patients who undergo stand-alone, single-level anterior lumbar interbody fusion (ALIF). This study will be the first multi-center clinical study to use clearly measurable outcomes from physical tests to compare the results of lumbar disc arthroplasty with disc fusion.

Detailed Description

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Physical capability testing will be conducted once before surgery and at 6 months and 1 year after surgery. Physical capability testing assesses the ability to perform a number of common tasks: the distance a subject can walk comfortably in 6 minutes; the amount of weight a subject can lift, push, pull, and carry; and the ability to squat and work bending forward in the kneeling and standing positions. The results of this testing will be evaluated to determine whether the subject's physical capability meets the physical requirements of their job, based on their responses to a pre-study questionnaire. Each physical capability testing session will require from 1 to 1 ½ hours of the subject's time. Physical capability testing will be provided without charge.

Conditions

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Physical Capability Outcomes

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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ProDisc-L

Subjects who received single-level ProDisc-L total disc replacement prior to physical capability evaluations

No interventions assigned to this group

anterior lumbar interbody fusion (AILF)

Subjects who received single-level anterior lumbar interbody fusion prior to physical capability evaluations

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

Eligible patients will meet the following criteria based on clinically appropriate criteria per standard of care at individual institutions which may include but are not limited to

* skeletally mature; BMI \< 40
* suffered from low-back pain with or without leg pain for 6 months or longer
* no evidence of spinal deformity on plain radiograph
* no evidence of angular instability on flexion extension radiographs
* severe and incapacitating low-back pain, defined as a score of 40% or greater on the Oswestry Disability Questionnaire
* a single level of degenerative disc disease at L34, L45, or L5-S1 on magnetic resonance imaging (MRI) scan
* discography, if indicated, reproduces pain at the level of degeneration noted on the MRI scan and is negative for pain reproduction at adjacent levels
* bone mineral density T-Score by DEXA Scan \>-1.0 for any skeletal region
* computed tomographic (CT) scan demonstrates the absence of pars defect at the index level
* CT scan demonstrates the absence of significant facet arthropathy at the index level
* considered reasonable candidates for surgery in regard to psychological factors as determined according to the standard of care at each participating center

Exclusion Criteria

* active systemic infection
* evidence of alcoholism
* spondylolisthesis of greater than grade 1
* clinically significant lumbar spinal stenosis
* allergy to implant materials
* isolated radicular syndrome
* vertebral body compromised by trauma at the index level.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Synthes USA HQ, Inc.

INDUSTRY

Sponsor Role collaborator

Gundersen Lutheran Medical Foundation

OTHER

Sponsor Role lead

Responsible Party

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Humbert (Drew) Sullivan

Chair, Department of Neurosurgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Humbert (Drew) G Sullivan, MD

Role: PRINCIPAL_INVESTIGATOR

Gundersen Lutheran Health System, LaCrosse, WI

Jack E Zigler, MD

Role: PRINCIPAL_INVESTIGATOR

Texas Back Institute, Plano, TX

John G Devine, MD

Role: PRINCIPAL_INVESTIGATOR

Eisenhower Army Medical Center, Augusta, GA

Locations

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University of Colorado Denver

Denver, Colorado, United States

Site Status

Christiana Spine Center

Newark, Delaware, United States

Site Status

Capital Regional Medical Center

Tallahassee, Florida, United States

Site Status

Orthopaedic Surgery Associates of Marquette, PC

Marquette, Michigan, United States

Site Status

Texas Back Institute

Plano, Texas, United States

Site Status

Gundersen Lutheran Health System

La Crosse, Wisconsin, United States

Site Status

Countries

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United States

References

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Kuslich SD, Ulstrom CL, Griffith SL, Ahern JW, Dowdle JD. The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial. Spine (Phila Pa 1976). 1998 Jun 1;23(11):1267-78; discussion 1279. doi: 10.1097/00007632-199806010-00019.

Reference Type BACKGROUND
PMID: 9636981 (View on PubMed)

Fairbank J, Frost H, Wilson-MacDonald J, Yu LM, Barker K, Collins R; Spine Stabilisation Trial Group. Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ. 2005 May 28;330(7502):1233. doi: 10.1136/bmj.38441.620417.8F. Epub 2005 May 23.

Reference Type BACKGROUND
PMID: 15911537 (View on PubMed)

Bertagnoli R, Yue JJ, Shah RV, Nanieva R, Pfeiffer F, Fenk-Mayer A, Kershaw T, Husted DS. The treatment of disabling single-level lumbar discogenic low back pain with total disc arthroplasty utilizing the Prodisc prosthesis: a prospective study with 2-year minimum follow-up. Spine (Phila Pa 1976). 2005 Oct 1;30(19):2230-6. doi: 10.1097/01.brs.0000182217.87660.40.

Reference Type BACKGROUND
PMID: 16205353 (View on PubMed)

Bao QB, Yuan HA. Prosthetic disc replacement: the future? Clin Orthop Relat Res. 2002 Jan;(394):139-45. doi: 10.1097/00003086-200201000-00016.

Reference Type BACKGROUND
PMID: 11795725 (View on PubMed)

McAfee PC, Cunningham B, Holsapple G, Adams K, Blumenthal S, Guyer RD, Dmietriev A, Maxwell JH, Regan JJ, Isaza J. A prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical outcomes. Spine (Phila Pa 1976). 2005 Jul 15;30(14):1576-83; discussion E388-90. doi: 10.1097/01.brs.0000170561.25636.1c.

Reference Type BACKGROUND
PMID: 16025025 (View on PubMed)

Fritzell P, Hagg O, Wessberg P, Nordwall A; Swedish Lumbar Spine Study Group. 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine (Phila Pa 1976). 2001 Dec 1;26(23):2521-32; discussion 2532-4. doi: 10.1097/00007632-200112010-00002.

Reference Type BACKGROUND
PMID: 11725230 (View on PubMed)

Brox JI, Sorensen R, Friis A, Nygaard O, Indahl A, Keller A, Ingebrigtsen T, Eriksen HR, Holm I, Koller AK, Riise R, Reikeras O. Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine (Phila Pa 1976). 2003 Sep 1;28(17):1913-21. doi: 10.1097/01.BRS.0000083234.62751.7A.

Reference Type BACKGROUND
PMID: 12973134 (View on PubMed)

Blumenthal S, McAfee PC, Guyer RD, Hochschuler SH, Geisler FH, Holt RT, Garcia R Jr, Regan JJ, Ohnmeiss DD. A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine (Phila Pa 1976). 2005 Jul 15;30(14):1565-75; discussion E387-91. doi: 10.1097/01.brs.0000170587.32676.0e.

Reference Type BACKGROUND
PMID: 16025024 (View on PubMed)

Zigler J, Delamarter R, Spivak JM, Linovitz RJ, Danielson GO 3rd, Haider TT, Cammisa F, Zuchermann J, Balderston R, Kitchel S, Foley K, Watkins R, Bradford D, Yue J, Yuan H, Herkowitz H, Geiger D, Bendo J, Peppers T, Sachs B, Girardi F, Kropf M, Goldstein J. Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine (Phila Pa 1976). 2007 May 15;32(11):1155-62; discussion 1163. doi: 10.1097/BRS.0b013e318054e377.

Reference Type BACKGROUND
PMID: 17495770 (View on PubMed)

Chung SS, Lee CS, Kang CS. Lumbar total disc replacement using ProDisc II: a prospective study with a 2-year minimum follow-up. J Spinal Disord Tech. 2006 Aug;19(6):411-5. doi: 10.1097/00024720-200608000-00007.

Reference Type BACKGROUND
PMID: 16891976 (View on PubMed)

Gillet P. The fate of the adjacent motion segments after lumbar fusion. J Spinal Disord Tech. 2003 Aug;16(4):338-45. doi: 10.1097/00024720-200308000-00005.

Reference Type BACKGROUND
PMID: 12902949 (View on PubMed)

Gross DP, Battie MC. Reliability of safe maximum lifting determinations of a functional capacity evaluation. Phys Ther. 2002 Apr;82(4):364-71.

Reference Type BACKGROUND
PMID: 11922852 (View on PubMed)

Reneman MF, Brouwer S, Meinema A, Dijkstra PU, Geertzen JH, Groothoff JW. Test-retest reliability of the Isernhagen Work Systems Functional Capacity Evaluation in healthy adults. J Occup Rehabil. 2004 Dec;14(4):295-305. doi: 10.1023/b:joor.0000047431.40598.47.

Reference Type BACKGROUND
PMID: 15638259 (View on PubMed)

Other Identifiers

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20092359

Identifier Type: OTHER

Identifier Source: secondary_id

2-09-05-002

Identifier Type: -

Identifier Source: org_study_id

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