StUdy oN Burst Fractures (SunBurst)

NCT ID: NCT05003180

Last Updated: 2025-02-04

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

202 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-01

Study Completion Date

2036-12-31

Brief Summary

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Thoracolumbar (TL) burst fractures are seen in all ages and usually associated with high-energy trauma. Treatment include both surgical and non-surgical options. In cases without neurological deficit or definite rupture of the posterior ligament complex (PLC) both surgical treatment and non-surgical treatment are considered standard of care. This study aims to compare outcome between surgical and non-surgical in patients with a single level TL burst fracture (AO A3/4) in a randomized controlled trial (RCT).

Detailed Description

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The study is an international, multicenter, randomized controlled trial. 202 patients with a single level TL burst fracture will be enrolled in the study. They will be randomized 1:1 to either surgery with posterior fixation or non-surgical treatment. The study is pragmatical in its approach, i.e., the treating physician can decide on details of the surgical treatment as well as details of the non-surgical treatment. In non-surgically treated patients brace treatment is not required, but a hyperextension brace may be offered. The subjects will be followed with patient reported outcomes, clinical assessments, and radiological assessments. Data will be collected from questionnaires, patient files or national registers to compare sick leave, medical complications, pharmaceutical prescriptions and overall costs for each treatment.

Conditions

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Thoracolumbar Burst Fracture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial. Subjects are identified through spine services at hospitals throughout Sweden and Norway. The subjects are screened for eligibility. Subjects are randomized in a 1:1 ratio to surgical or non-surgical treatment.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Surgical

Surgical stabilization. Brace treatment will not be used postoperative. Early ambulation after surgery is encouraged. Surgery is to be performed within 2 weeks from the injury. The choice of supplier and brand of implants are based on the preference of each participating center.

Physiotherapy and other measures of rehabilitation are prescribed on an individual basis.

Group Type ACTIVE_COMPARATOR

Surgical stabilization

Intervention Type PROCEDURE

The surgical stabilization can be either open or minimally invasive. The recommended procedure is posterior fixation with pedicle screws and rods. Both short and long segment fixation are allowed in the study. It is up to the treating surgeon to decide on fusion or decompression. If feasible, pedicle screws are inserted in the fractured vertebra.

Non-surgical treatment

No surgical stabilization is performed. Early ambulation after treatment randomization is encouraged. Brace treatment is not required, but a standard three-point hyperextension brace may be offered up to 3 months for pain relief. The choice of supplier and brand of brace are based on the preference of each participating center. The brace will only be used upon mobilization. Brace use will be estimated by the patient at the 3-4 months follow-up.

Physiotherapy and other measures of rehabilitation are prescribed on an individual basis.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Surgical stabilization

The surgical stabilization can be either open or minimally invasive. The recommended procedure is posterior fixation with pedicle screws and rods. Both short and long segment fixation are allowed in the study. It is up to the treating surgeon to decide on fusion or decompression. If feasible, pedicle screws are inserted in the fractured vertebra.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* A single level thoracolumbar (Th10-L3) burst fracture, A3 or A4, according to the AO Spine classification
* Aged 18-66 years
* Informed consent
* Acute injury with diagnosis and treatment within 2 weeks
* May have minor fractures in adjacent vertebras if these fractures in themselves would not have resulted in any treatment
* May have a single nerve root injury

Exclusion Criteria

* Unable to consent, no consent given or not informed
* Neurological injury involving more than a single level root, i.e., spinal cord and/or cauda equina injury
* Definite rupture of the posterior tension band (through bony and/or ligamentous structures) verified on MRI
* Patients with ankylosing spinal disorders spanning the fracture area
* Prior spinal surgeries within the fractured area
* Open vertebral fracture
* Additional injury which would impair early ambulation, e.g., long bone fractures, severe head injury, long-lasting intensive care
* Patients not deemed suitable due to severe co-morbidities. (E.g., established osteoporosis that would impair the possibility to maintain integrity of spinal implants, pathological fractures, severe cardiac or pulmonary compromise, or other systemic disease that would result in such high anesthesiologic risk that surgery would not be attempted.)
* Patients already included in the study cannot be randomized again if they get an additional spine fracture
Minimum Eligible Age

18 Years

Maximum Eligible Age

66 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Uppsala University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Umeå

OTHER

Sponsor Role collaborator

University Hospital, Linkoeping

OTHER

Sponsor Role collaborator

Skane University Hospital

OTHER

Sponsor Role collaborator

Region Örebro County

OTHER

Sponsor Role collaborator

Stockholm South General Hospital

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role collaborator

Helse Stavanger HF

OTHER_GOV

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role collaborator

Kalmar County Hospital

OTHER

Sponsor Role collaborator

Ryhov County Hospital

OTHER

Sponsor Role collaborator

Halmstad County Hospital

OTHER

Sponsor Role collaborator

Centrallasarettet Västerås

OTHER

Sponsor Role collaborator

St. Olavs Hospital

OTHER

Sponsor Role collaborator

Uppsala University

OTHER

Sponsor Role lead

Responsible Party

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Paul Gerdhem

MD, PhD, Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paul Gerdhem, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Uppsala University, Uppsala University Hospital and Karolinska Institutet

Filip Dolatowski, MD, PhD

Role: STUDY_DIRECTOR

Oslo University Hospital

Locations

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Haukeland University Hospital

Bergen, , Norway

Site Status

Akershus University Hospital

Oslo, , Norway

Site Status

Oslo University Hospital

Oslo, , Norway

Site Status

Stavanger University Hospital

Stavanger, , Norway

Site Status

St. Olavs Hospital

Trondheim, , Norway

Site Status

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Halmstad Hospital

Halmstad, , Sweden

Site Status

Ryhov Hospital

Jönköping, , Sweden

Site Status

Kalmar Hospital

Kalmar, , Sweden

Site Status

Linköping University Hospital

Linköping, , Sweden

Site Status

Skåne University Hospital

Malmo, , Sweden

Site Status

Örebro University Hospital

Örebro, , Sweden

Site Status

Karolinska University Hospital

Stockholm, , Sweden

Site Status

Stockholm South General Hospital

Stockholm, , Sweden

Site Status

University Hospital of Umeå

Umeå, , Sweden

Site Status

Uppsala University Hospital

Uppsala, , Sweden

Site Status

Central Hospital of Västerås

Västerås, , Sweden

Site Status

Countries

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Norway Sweden

References

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Related Links

Access external resources that provide additional context or updates about the study.

https://www.socialstyrelsen.se/statistik-och-data/register/patientregistret/

Information on the National Board of Health and Welfare,The National Patient Register.

https://www.socialstyrelsen.se/statistik-och-data/register/lakemedelsregistret/

Information on the National Board of Health and Welfare, The Swedish Prescribed Drug Register.

https://www.socialstyrelsen.se/statistik-och-data/register/dodsorsaksregistret/

Information in Swedish on the National Board of Health and Welfare, Cause of Death Register (Socialstyrelsen. Dödsorsaksregistret.)

Other Identifiers

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2020-00493

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SB-PG-PF-OW-SM-2021-SunBurst

Identifier Type: -

Identifier Source: org_study_id

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