Randomized Controlled Trial of Internal Fixation Reconstruction With Stent Screw in the Treatment of Kummell's Disease

NCT ID: NCT06093087

Last Updated: 2023-10-23

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-01-01
• Study Completion Date: 2027-09-01

Brief Summary

This study is a multicenter, prospective, double-blind, randomized controlled trial using a parallel two-arm design to investigate whether the postoperative 6-month quality of life, vertebral stability, complication of patients with osteoporotic vertebral compression fractures (Kummell's disease) are better with the use of stent screw internal fixation and percutaneous bone cement reconstruction technique compared to patients undergoing traditional percutaneous balloon kyphoplasty (BKP) for vertebral augmentation

Conditions

BKP; Osteoporotic Vertebral Compression Fracture; Kummell's Disease; Stent-screw-assisted Internal Fixation

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

SAIF

patients will be treated with kyphoplasty surgery combined with pedicular screw-assisted internal fixation for vertebral augmentation

Group Type: EXPERIMENTAL

SAIF

Intervention Type: PROCEDURE

The patient was placed in a prone position under general anesthesia. Using a C-arm X-ray machine and a positioning plate for navigation, the target position on the vertebral body was located one the surface of the body. The puncture needle core was withdrawn after puncturing, and a guide needle was inserted. After removing the puncture needle sleeve, a hollow bone cement screw was screwed into the anterior column of the vertebral body through the guide needle. Subsequently, bone cement was injected into the appropriate position through the bone cement screw to restore the vertebral height

BKP

patients will be treated with balloon kyphoplasty surgery for vertebral augmentation

Group Type: ACTIVE_COMPARATOR

BKP

Intervention Type: PROCEDURE

The patient was placed in a prone position after general anesthesia. Using a C-arm X-ray machine and a positioning plate for guidance, the target position on the vertebral body was located from the surface of the body. A puncture needle sleeve was inserted into the vertebral body. A PKP balloon was then inserted to perform vertebral restoration. After removing the balloon, an appropriate amount of bone cement was injected to ensure even distribution within the vertebral body. Vertebral height augmentation and restoration will then be achieved.

Interventions

SAIF

The patient was placed in a prone position under general anesthesia. Using a C-arm X-ray machine and a positioning plate for navigation, the target position on the vertebral body was located one the surface of the body. The puncture needle core was withdrawn after puncturing, and a guide needle was inserted. After removing the puncture needle sleeve, a hollow bone cement screw was screwed into the anterior column of the vertebral body through the guide needle. Subsequently, bone cement was injected into the appropriate position through the bone cement screw to restore the vertebral height

Intervention Type: PROCEDURE

BKP

The patient was placed in a prone position after general anesthesia. Using a C-arm X-ray machine and a positioning plate for guidance, the target position on the vertebral body was located from the surface of the body. A puncture needle sleeve was inserted into the vertebral body. A PKP balloon was then inserted to perform vertebral restoration. After removing the balloon, an appropriate amount of bone cement was injected to ensure even distribution within the vertebral body. Vertebral height augmentation and restoration will then be achieved.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Age 60 or above, gender not specified.
• Must have one to three vertebral segments with vertebral compression fracture (VCF) located between T5 and L5, attributed to underlying primary or secondary osteoporosis rather than cancer.
• All VCFs must exhibit the following radiographic changes: according to Genant's criteria, acute (≤4 months) decrease in anterior, middle, or posterior vertebral height by at least one grade (20-25% reduction in vertebral height, 10-20% reduction in vertebral area) compared to previous X-ray, CT, or MRI results.
• All VCFs for treatment must occur within four months or less.
• All VCFs for treatment must be technically feasible and clinically suitable for BKP or SAIF surgery.
• Pre-treatment back pain NRS score must be ≥ 7 and ineffective with conservative (non-surgical) treatment.
• Pre-treatment Oswestry Disability Index must be ≥ 30 (on a scale of 0-100).
• Patient's life expectancy must be ≥ 12 months.
• Must declare willingness to participate in all post-operative follow-ups.
• Must be capable of understanding the risks and benefits of the study and willing to provide written informed consent.

Exclusion Criteria

• Vertebral morphology or fracture morphology unsuitable for balloon kyphoplasty. VCF caused by high-energy trauma.
• Asymptomatic VCF or vertebral bodies amenable to prophylactic treatment.
• VCF at the same site associated with primary bone tumors.
• Back pain caused by reasons other than acute fractures. VCF with an estimated fracture time of more than 4 months, based on clinical assessment (radiological evidence and patient history).
• VCF associated with secondary radiculopathy or neurological compromise.
• VCF requiring spinal surgery other than BKP or SAIF.
• Spinal cord compression or vertebral canal injury requiring decompression surgery.
• Combined clinical conditions unsuitable for surgery or affecting subsequent long-term data collection or follow-up.
• Allergy to any component during the surgical procedure (e.g., bone cement, contrast agents).
• Concurrent participation in another clinical study.
• Pregnancy during the study or planning to become pregnant.

• Minimum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Wanli Li, MD

Role: CONTACT

liwanli@zju.edu.cn

+86 13967116021

Other Identifiers

LWL_2023

Identifier Type: -

Identifier Source: org_study_id