Stand-Alone Cage Verus Anterior Plating for Anterior Cervical Discectomy and Fusion.

NCT ID: NCT03312192

Last Updated: 2021-09-16

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-17

Study Completion Date

2020-12-31

Brief Summary

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The purpose of this study is to compare the clinical results between two different techniques for ACDF: 1. Stand-alone ACDF, which means the placement of an interbody device (cage) without anterior fixation or plating; 2. ACDF with and interbody cage and anterior plating for fixation. Both of these procedures are commonly performed at Rush with unclear advantage of one procedure over the other. Both have been associated with good to excellent clinical outcomes. The devices used in this study are approved by the Food and Drug Administration (FDA).

Detailed Description

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Anterior cervical discectomy and fusion (ACDF) is one the most common procedures performed by spine surgeons. Although ACDF with autologous bone graft and anterior plating is commonly performed, this procedure may be associated with postoperative dysphagia, significant costs and adjacent segment pathology. To address these concerns, a number of surgeons have opted to utilize an interbody cage in a stand-alone fashion with good to excellent results. However, the published data is limited and currently there in no consensus among spine surgeons regarding the best technique to achieve fusion and improve clinical outcomes in patients with degenerative disc disease in the cervical spine.

Conditions

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Degenerative Disc Disease Cervical Spine Degeneration

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1\. Stand-alone ACDF, which means the placement of an interbody device (cage) without anterior fixation or plating; 2. ACDF with and interbody cage and anterior plating for fixation.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Plate and Cage

ACDF with interbody cage and anterior plating.

Group Type ACTIVE_COMPARATOR

Interbody Cage and Anterior Plating

Intervention Type DEVICE

Anterior cervical discectomy and fusion with interbody cage placement and anterior plating

Stand Alone Cage

ACDF with stand alone interbody cage without anterior plating

Group Type ACTIVE_COMPARATOR

Interbody Cage

Intervention Type DEVICE

Anterior cervical discectomy and fusion with interbody cage placement

Interventions

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Interbody Cage

Anterior cervical discectomy and fusion with interbody cage placement

Intervention Type DEVICE

Interbody Cage and Anterior Plating

Anterior cervical discectomy and fusion with interbody cage placement and anterior plating

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing a primary 1- to 2-level ACDF

(a) Diagnosis: myelopathy, radiculopathy, myeloradiculopathy, stenosis, herniated nucleus pulposus, degenerative disc disease, spondylosis, osteophytic complexes, and foraminal stenosis
* Patients able to provide informed consent

Exclusion Criteria

* Cervical spine trauma
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rush University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Carla Edwards

Clinical Research Manger

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kern Singh, MD

Role: PRINCIPAL_INVESTIGATOR

Rush University Medical Center

Locations

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Rush University Medical Center

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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Ji GY, Oh CH, Shin DA, Ha Y, Kim KN, Yoon DH, Yudoyono F. Stand-alone Cervical Cages Versus Anterior Cervical Plates in 2-Level Cervical Anterior Interbody Fusion Patients: Analysis of Adjacent Segment Degeneration. J Spinal Disord Tech. 2015 Aug;28(7):E433-8. doi: 10.1097/BSD.0b013e3182a355ad.

Reference Type BACKGROUND
PMID: 23897053 (View on PubMed)

Choi KC, Ryu KS, Lee SH, Kim YH, Lee SJ, Park CK. Biomechanical comparison of anterior lumbar interbody fusion: stand-alone interbody cage versus interbody cage with pedicle screw fixation -- a finite element analysis. BMC Musculoskelet Disord. 2013 Jul 26;14:220. doi: 10.1186/1471-2474-14-220.

Reference Type BACKGROUND
PMID: 23890389 (View on PubMed)

Oh JK, Kim TY, Lee HS, You NK, Choi GH, Yi S, Ha Y, Kim KN, Yoon DH, Shin HC. Stand-alone cervical cages versus anterior cervical plate in 2-level cervical anterior interbody fusion patients: clinical outcomes and radiologic changes. J Spinal Disord Tech. 2013 Dec;26(8):415-20. doi: 10.1097/BSD.0b013e31824c7d22.

Reference Type BACKGROUND
PMID: 22367466 (View on PubMed)

Lee MJ, Dettori JR, Standaert CJ, Ely CG, Chapman JR. Indication for spinal fusion and the risk of adjacent segment pathology: does reason for fusion affect risk? A systematic review. Spine (Phila Pa 1976). 2012 Oct 15;37(22 Suppl):S40-51. doi: 10.1097/BRS.0b013e31826ca9b1.

Reference Type BACKGROUND
PMID: 22872219 (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)

Cho SK, Riew KD. Adjacent segment disease following cervical spine surgery. J Am Acad Orthop Surg. 2013 Jan;21(1):3-11. doi: 10.5435/JAAOS-21-01-3.

Reference Type BACKGROUND
PMID: 23281466 (View on PubMed)

Kraemer P, Fehlings MG, Hashimoto R, Lee MJ, Anderson PA, Chapman JR, Raich A, Norvell DC. A systematic review of definitions and classification systems of adjacent segment pathology. Spine (Phila Pa 1976). 2012 Oct 15;37(22 Suppl):S31-9. doi: 10.1097/BRS.0b013e31826d7dd6.

Reference Type BACKGROUND
PMID: 22885835 (View on PubMed)

Mobbs RJ, Rao P, Chandran NK. Anterior cervical discectomy and fusion: analysis of surgical outcome with and without plating. J Clin Neurosci. 2007 Jul;14(7):639-42. doi: 10.1016/j.jocn.2006.04.003.

Reference Type BACKGROUND
PMID: 17532499 (View on PubMed)

Savolainen S, Rinne J, Hernesniemi J. A prospective randomized study of anterior single-level cervical disc operations with long-term follow-up: surgical fusion is unnecessary. Neurosurgery. 1998 Jul;43(1):51-5. doi: 10.1097/00006123-199807000-00032.

Reference Type BACKGROUND
PMID: 9657188 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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14021901

Identifier Type: -

Identifier Source: org_study_id

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