Clinical Trial Comparing Decompression With and Without Coflex™ Interlaminar Technology Treating Lumbar Spinal Stenosis

NCT ID: NCT01316211

Last Updated: 2020-06-09

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

246 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-01-31

Study Completion Date

2014-08-31

Brief Summary

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A 2 year comparative evaluation of clinical outcome in the treatment of degenerative spinal stenosis with concomitant low back pain by decompression with and without additional stabilization using the coflex® Interlaminar Technology

Detailed Description

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The coflex® implant for interlaminar stabilization has been in clinical use for more than 10 years and is CE-certified according to the standards and approved in the United States.

This was a randomized multicenter study to collect prospective data for potential improvement in the therapy of low back pain during the treatment of spinal stenosis. The study was conducted in Germany.

Conditions

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Spinal Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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coflex™

Implantation of coflex™ device in assigned patients

Group Type ACTIVE_COMPARATOR

Implantation of coflex™ after surgical decompression

Intervention Type DEVICE

The device will be implanted after surgical decompression in patients with spinal stenosis.

Surgical decompression

Surgical decompression in patients with spinal stenosis without stabilization by an additional implant.

Group Type ACTIVE_COMPARATOR

Surgical decompression

Intervention Type PROCEDURE

Surgical decompression in patients with spinal stenosis without stabilization by an additional implant

Interventions

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Implantation of coflex™ after surgical decompression

The device will be implanted after surgical decompression in patients with spinal stenosis.

Intervention Type DEVICE

Surgical decompression

Surgical decompression in patients with spinal stenosis without stabilization by an additional implant

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Radiographic confirmation of clinical symptoms of at least moderate degenerative spinal stenosis, with constriction of the central spinal canal of one or two adjacent segments in the region L3 to L5 with the need for decompression.

If necessary additional decompression in the adjacent segment(s) may be performed avoiding any instability in the affected segment.

In addition the following may exist (but is not obligatory):
* hypertrophy of the facet joints and subarticular recessus stenosis in the relevant segment or
* stenosis of the foramen in the relevant segment
* and/or stable retrolisthesis up to grade I verified by flexion-/extension X-ray films.
2. Radiographic confirmation of no translatory instability in the main segment as well as in adjacent segments (dynamic translatory instability ≤ 3 mm).
3. VAS back pain score of at least 50 mm on a 100 mm scale (for acute back pain or a period of at least 3 month of back pain before the onset of leg pain).
4. Minimum of 3 months conservative therapy without improvement of symptoms.
5. Age \>40 years.
6. Oswestry Low Back Pain Disability Questionnaire score of at least 18/45 (40%) for German sites or 20/50 (40%) for the US sites (The question about sexual life will be excluded).
7. Suitability of the patient for a posterior surgery procedure.
8. Mental and physical ability of patient to follow the protocol according to compliance to time schedule, treatment plan, fill in of CRF pages and further study procedures.
9. Personally signed informed consent form before the start of any study related procedures.

Exclusion Criteria

Any of the following will exclude a subject from the study:

1. Preceding fusion or decompression surgery of the lumbar spine or preceding nucleotomy of the segments of concern (also if nucleotomy becomes necessary during surgery).
2. Radiographically confirmed damage of the vertebral body in the segment of concern in the lumbar spine (e.g. osteoporotic compression fracture or because of tumors)
3. Isthmic and degenerative spondylolisthesis (anterolisthesis; retrolisthesis \> grade I) or spondylolysis (Pars fracture).
4. Degenerative lumbar scoliosis (\> 25°).
5. Adipositas (obesity). Defined as a body mass index \>40.
6. Pregnancy, or wish to get pregnant during the course of the study.
7. Known allergy for titanium and titanium alloys.
8. Fluoride infections - both systemic and local.
9. History of severe peripheral neuropathy.
10. Significant peripheral vascular disease (claudication intermittens ≥ stage 2b).
11. M. Paget or osteomalacia or other metabolic bone disorders.
12. Cauda equina syndrome.
13. Communicating diseases, including HIV, active hepatitis
14. Patients who are lawfully kept in an institution.
15. Subjects who, in the opinion of the investigator, will be inappropriate for inclusion into this clinical trial or will not comply with requirements of the study.
16. Subjects who participated in a clinical observation or therapy with X-ray during the last 10 years.
17. Subjects who participate(d) in another clinical trial (within the last 4 weeks) that might influence the safety and effectiveness assessment of this trial.
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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MDT Medical Device Testing GmbH

INDUSTRY

Sponsor Role collaborator

MCRA

INDUSTRY

Sponsor Role collaborator

Paradigm Spine

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Oberlinklinik Potsdam Orthopädische Fachklinik

Potsdam, Brandenburg, Germany

Site Status

Orthopädische Universitätsklinik Frankfurt a.M.

Frankfurt a.M., Hesse, Germany

Site Status

Chirurgische Universitätsklinik Rostock Neurochirurgie

Rostock, Mecklenburg-Vorpommern, Germany

Site Status

Otto-von-Guericke-Universität Magdeburg Klinik für Orthopädie

Magdeburg, Saxony-Anhalt, Germany

Site Status

Ostseeklinik Damp Neurochirurgie

Damp, Schleswig-Holstein, Germany

Site Status

Klinik für Neurochirurgie Lübeck

Lübeck, Schleswig-Holstein, Germany

Site Status

Klinik für Wirbelsäulenchirurgie mit Skoliosezentrum Klinikum Neustadt

Neustadt, Schleswig-Holstein, Germany

Site Status

Klinikum Ingolstadt Neurochirurgie

Ingolstadt, , Germany

Site Status

Countries

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Germany

References

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Schmidt S, Franke J, Rauschmann M, Adelt D, Bonsanto MM, Sola S. Prospective, randomized, multicenter study with 2-year follow-up to compare the performance of decompression with and without interlaminar stabilization. J Neurosurg Spine. 2018 Apr;28(4):406-415. doi: 10.3171/2017.11.SPINE17643. Epub 2018 Jan 26.

Reference Type DERIVED
PMID: 29372860 (View on PubMed)

Other Identifiers

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06k004

Identifier Type: -

Identifier Source: org_study_id

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