Incomplete Cervical SCI Without Instability

NCT ID: NCT05653206

Last Updated: 2025-07-24

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

RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-12-11

Study Completion Date

2027-08-01

Brief Summary

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A multicenter, international, prospective, observational case series patient cohort with incomplete cervical SCI without instability will be enrolled to obtain information and data that could inform the feasibility of administering a set of additional core and optional outcome assessments in cervical SCI patients to capture the aspects of neurologic impairment. Baseline, intraoperative, and postoperative characteristics, including demographics, injury details, treatment details, neurological assessments, gait and balance assessments and upper extremity assessments, will be recorded for adult patients.

Detailed Description

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This prospective multicenter study will enroll 50 adult patients with acute traumatic cervical SCI with ISNCSCI AIS Grade D or sensory deficits only without biomechanical instability.

Patients will be assessed at the baseline visit and subsequently be followed up at 3 and 6 months. All decisions regarding the treatment and clinical management will be left to the attending spinal surgeon and will follow the local standard of care.

The core outcome assessments include:

* Neurological status by the ISNCSCI
* Patient-reported outcome measures (PROMs) of Short Form-36 (SF-36) v2 and Neuropathic Pain Scale (NPS)
* The Spinal Cord Independence Measure (SCIM) v3
* Gait and balance evaluated using the ten-meter walk test (10mWT) and Walking Index for Spinal Cord Injury (WISCI) v2
* Upper extremity impairment evaluated using the grip strength with digital dynamometry, pinch strength (key pinch and tip-to-tip pinch), and the Partial Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) v2.

All core outcome assessments will be performed at the baseline, 3-, and 6-month visits except for the PROMs, SCIM v3, key pinch and tip-to-tip pinch, which will be assessed only at the 3- and 6-month visits.

The optional outcome assessment is the multiparametric quantitative spinal cord magnetic resonance imaging (MRI)/diffusion tensor imaging (DTI) which will be performed at baseline, 3-, and 6-month visits if it is done at the surgeon's discretion.

The goal of this study is to obtain information and data that could inform the feasibility of administering a set of additional core and optional outcome assessments in cervical SCI patients with incomplete tetraplegia without spinal instability to capture the aspects of neurologic impairment that may not be well represented in the ISNCSCI examination.

Conditions

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Cervical Spinal Cord Injury

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Nonsurgical treatment

Cervical collar, Halo ring, Halo vest, cervical braces, skeletal skull traction, MAP, steroids, observation or bedrest

Intervention Type PROCEDURE

Surgical treatment

Anterior discectomy and instrumented fusion (single level), Anterior discectomy and instrumented fusion (multi-level), Posterior decompression-laminectomy, Posterior decompression-laminoplasty, Posterior decompression and instrumented fusion, Combined anterior and posterior decompression and instrumented fusion

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18-80 years, inclusive
* Diagnosis of acute traumatic cervical SCI with ISNCSCI AIS Grade D or sensory deficits only within 92 hours post injury
* Cervical neurological level of injury (C2-C8)
* MRI, using any imaging protocols (conventional, multiparametric, or quantitative), taken according to standard of care
* Presence of spinal cord compression on the MRI
* Absence of biomechanical instability to the extent that would mandate stabilization surgery by the treating surgeon
* Ability to provide informed consent according to the IRB/EC defined and approved procedures

Exclusion Criteria

* Nontraumatic SCI
* Concomitant traumatic brain injury or polytrauma that could preclude accurate or reliable assessments of the outcome assessments
* Uncontrolled severe systemic diseases, preexisting neurological, musculoskeletal, or general medical conditions which could preclude accurate assessments or FUs
* Individuals unable to undergo MRI
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AO Foundation, AO Spine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jefferson Wilson

Role: PRINCIPAL_INVESTIGATOR

Unity Health Toronto

Locations

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San Francisco General Hospital

San Francisco, California, United States

Site Status RECRUITING

UMD STC Neurosurgery Clinic

Baltimore, Maryland, United States

Site Status RECRUITING

Medical college of Winsconsine, Neurosurgery

Milwaukee, Wisconsin, United States

Site Status RECRUITING

Instituto de Ortopedia E Traumatologia Do Hospital Das Clinicas Da Universidade de Sao Paulo

São Paulo, , Brazil

Site Status RECRUITING

St. Michael's Hospital

Toronto, , Canada

Site Status RECRUITING

Toronto Western Hospital University Health Network

Toronto, , Canada

Site Status RECRUITING

Vancouver Spine Research Program, Blusson Spinal Cord Centre

Vancouver, , Canada

Site Status RECRUITING

BG Klinikum Murnau gGmb, BGU Murnau, Trauma Center Murnau

Murnau am Staffelsee, , Germany

Site Status RECRUITING

Indian Spinal Injuries Centre

New Delhi, , India

Site Status RECRUITING

Orthopaedics, Centro Hospitalar Universitário do Porto

Porto, , Portugal

Site Status RECRUITING

Countries

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United States Brazil Canada Germany India Portugal

Central Contacts

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Felix Thomas

Role: CONTACT

+41 79 671 47 98

Mariana Cabeleira

Role: CONTACT

Facility Contacts

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Anthony DiGiorgio

Role: primary

Bizhan Aarabi

Role: primary

Aditya Vedantam

Role: primary

Alexandre Fogaca Cristante

Role: primary

Jefferson Wilson

Role: primary

Michael Fehlings

Role: primary

Brian Kwon

Role: primary

Lukas Grassner

Role: primary

Harvinder Singh Chhabra

Role: primary

Ricardo Rodrigues-Pinto

Role: primary

Other Identifiers

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IN-TWIN

Identifier Type: -

Identifier Source: org_study_id

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