Dynamic Cervical Implant vs. Anterior Cervical Discectomy and Fusion

NCT ID: NCT05101967

Last Updated: 2021-11-01

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-01

Study Completion Date

2024-05-01

Brief Summary

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Comparison between Dynamic Cervical Implant as a recently introduced technique in our department and the conventional Anterior Cervical Discectomy and Fusion in management of single-level cervical disc prolapse.

Detailed Description

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Anterior cervical discectomy and fusion (ACDF) is considered to be a highly successful surgical technique for cervical spondylosis associated with brachialgia and/or myelopathy. Non-union accounts for more than two-thirds of failures in ACDF surgeries and iliac bone graft morbidity is also reported in about one-third of multilevel fusion operations. There are many types of cages used to avoid the complications associated with iliac bone grafting.These problems include persistent donor-site pain, infection, hematoma formation, iliac crest fracture, and neuralgia parasthetica.

However, in spite of being successful for many years, ACDF has its own complications in the form of non-union, implant failure, and adjacent level disease which occurs due to the excessive motion observed at the levels immediately above and/or below the index level. It has been proven to provide clinical stability after decompression.. However, although it achieves long-term success, ACDF is not without complications as there have been reports of pseudoarthrosis, implant failure, and adjacent level disease which occurs due to the significant amount of increased motion observed at the levels immediately above and below the fusion. However, greater compensation occurred at the inferior segments compared to the superior segments for the lower level fusions.

Dynamic cervical Implant (DCI) is a titanium implant, originally invented in 2002 by Dr. Guy Matgé, Luxembourg. It was introduced in clinical use, in 2004. The design was modified to better accommodate the normal disc anatomy. The DCI implant with its motion preservation characters is unique implant. It stabilizes the cervical spine while still offering a limited, controlled flexion and extension movements allowing the spine to dynamically perform its function. It also acts as a shock absorber, preventing accelerated degeneration in adjacent segments. Thus, the DCI implant aims at combining the advantages of the gold standard "fusion" with a motion preservation philosophy.

This study aims to

* compare the clinical and radiographic outcomes of ACDF versus DCI in patients with degenerative cervical radiculopathy and/or myelopathy operated upon at Assiut University Hospital.
* Give the effective treatment, pain control and can detect the best method could be used in such cases.

I.

• Improve the outcome of these patients and decease rate of recurrence and complications

Conditions

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Cervical Disc Prolapse

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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Dynamic Cervical Implant

Group Type EXPERIMENTAL

Dynamic Cervical Implant

Intervention Type PROCEDURE

Cervical discectomy through anterior approach with replacement of disc by dynamic implant

Anterior Cervical Discectomt and Fusion

Group Type ACTIVE_COMPARATOR

Anterior Cervical Discectomt and Fusion

Intervention Type PROCEDURE

Cervical discectomy through anterior approach with putting of cervical cage.

Interventions

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Dynamic Cervical Implant

Cervical discectomy through anterior approach with replacement of disc by dynamic implant

Intervention Type PROCEDURE

Anterior Cervical Discectomt and Fusion

Cervical discectomy through anterior approach with putting of cervical cage.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients with single level cervical disc prolapse in the subaxial cervical vertebrae (C3 - C7) confirmed by MRI.
2. Age of the patient is between 18- 60 years old of both sex.
3. Patients are fit for surgery..

Exclusion Criteria

1. Patients with multilevel cervical disc prolapse.
2. Patients with recurrent disc prolapse.
3. Spinal deformity
4. Spinal instability.
5. Patients who are unfit for surgery
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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H A Othman

Registrar

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed E Abokresha, Professor

Role: STUDY_CHAIR

Assiut University

Shady A Hassaan, MD

Role: STUDY_DIRECTOR

Assiut University

Hazem A Othman, MSc

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Central Contacts

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Hazem A Othman, MSc

Role: CONTACT

Phone: 01060324743

Email: [email protected]

Other Identifiers

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DCI vs. ACDF

Identifier Type: -

Identifier Source: org_study_id