A Pivotal Study of rhBMP-2/ACS/LT-CAGE® Device for Anterior Lumbar Interbody Fusion in Patients With Degenerative Disc Disease

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Medtronic Spinal and Biologics
ClinicalTrials.gov Identifier:
NCT01491425
First received: December 12, 2011
Last updated: August 1, 2013
Last verified: December 2011
  Purpose

This study is designed to assess the safety and effectiveness of the rhBMP-2/ACS/LT-CAGE® Device using laparoscopic surgical technique as compared to an historical control group treated with Autogenous Bone/LT-CAGE® Device using an open surgical technique in patients with symptomatic degenerative disc disease.


Condition Intervention
Degenerative Disc Disease
Device: rhBMP-2/ACS//LT-CAGE® Device
Device: Autogenous Bone//LT-CAGE® Device

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Clinical Investigation of Recombinant Human Bone Morphogenetic Protein-2 and Absorbable Collagen Sponge With the LT-CAGE® Device for Anterior Lumbar Interbody Fusion in Patients With Symptomatic Degenerative Disc Disease

Further study details as provided by Medtronic Spinal and Biologics:

Primary Outcome Measures:
  • Overall Success [ Time Frame: 24 month ] [ Designated as safety issue: Yes ]

    A patient will be considered an overall success if all of the following conditions are met:

    1. fusion;
    2. pain/disability (Oswestry) improvement;
    3. maintenance or improvement in neurological status;
    4. no serious adverse event classified as implant associated or implant/surgical procedure associated;
    5. no additional surgical procedure classified as a "failure."


Secondary Outcome Measures:
  • Disc Height Measurement [ Time Frame: 24 month ] [ Designated as safety issue: No ]
  • General Health Status (SF-36) [ Time Frame: 24 month ] [ Designated as safety issue: No ]
  • Pain Status (Numerical Rating Scale) [ Time Frame: 24 month ] [ Designated as safety issue: No ]
  • Patient Satisfaction [ Time Frame: 24 month ] [ Designated as safety issue: No ]
  • Patient Global Perceived Effect [ Time Frame: 24 month ] [ Designated as safety issue: No ]

Enrollment: 134
Study Start Date: November 1998
Study Completion Date: October 2002
Primary Completion Date: October 2002 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: rhBMP-2/ACS Device: rhBMP-2/ACS//LT-CAGE® Device
LT-CAGE® device with recombinant human bone morphogenetic protein-2 ( rhBMP-2) and the absorbable collagen sponge (ACS).
Other Name: Recombinant human bone morphogenetic protein-2
Active Comparator: Autogenous Bone
The control group of patients from another study (Protocol ID: C-9702 Pivotal Study of rhBMP-2/ACS/LT-CAGE® Device for Anterior Lumbar Interbody Fusion in Patients With Symptomatic DDD).
Device: Autogenous Bone//LT-CAGE® Device
LT-CAGE® device with autogenous bone taken from the iliac crest.
Other Name: Autograft

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Has degenerative disc disease as noted by back pain of discogenic origin, with or without leg pain, with degeneration of the disc confirmed by patient history ( e.g.,pain [leg, back, or symptoms in the sciatic nerve distribution], function deficit and/or neurological deficit)and radiographic studies ( e.g., CT, MRl, X-Ray, etc.) to include one or more of the following:

    • instability( defined as angular motion > 5° and/or translation >= 2-4mm, based on Flex/Ext radiographs);
    • osteophyte formation;
    • decreased disc height;
    • thickening of ligamentous tissue;
    • disc degeneration or herniation; and/or
    • facet joint degeneration.
  2. Has preoperative Oswestry score > 35.
  3. Has no greater than Grade 1 spondylolisthesis utilizing Meyerding's Classification (Meyerding HW, 1932.).
  4. Has single-level symptomatic degenerative involvement from L4 to S1.
  5. Is at least 18 years of age, inclusive, at the time of surgery.
  6. Has not responded to non-operative treatment (e.g., bed rest, physical therapy, medications, spinal injections, manipulation, and/or TENS) for a period of at least 6 months.
  7. If female of child-bearing potential, who is not pregnant or nursing, and who agrees to use adequate contraception for 16 weeks following surgery.
  8. Is willing and able to comply with the study plan and sign the Patient Informed Consent Form.

Exclusion Criteria:

  1. Had previous anterior spinal fusion surgical procedure at the involved level.
  2. Has posterior spinal instrumentation (which will not be removed) stabilizing the involved level or has had a previous posterior lumbar interbody fusion procedure at the involved level.
  3. Has a condition which requires postoperative medications that interfere with fusion, such as steroids.
  4. Has been previously diagnosed with osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated.
  5. Has presence of active malignancy.
  6. Has overt or active bacterial infection, either local or systemic.
  7. Is grossly obese, i.e., weight > 40% over ideal for their age and height.
  8. Has fever ( temperature > 101° F oral) at the time of surgery.
  9. Has a documented titanium alloy allergy or intolerance.
  10. Is mentally incompetent. if questionable, obtain psychiatric consult.
  11. Has a Waddell Signs of Inorganic Behavior score of 3 or greater.
  12. Is a prisoner.
  13. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug usage.
  14. Is a tobacco user at the time of surgery.
  15. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal fusion surgery (e.g., steroids or methotrexate).
  16. Has a history of autoimmune disease (Systemic Lupus Erythematosus or Dermatomyositis).
  17. Has a history of exposure to injectable collagen implants.
  18. Has a history of hypersensitivity to protein pharmaceuticals (monoclonal antibodies or gamma globulins) or collagen.
  19. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following rhBMP-2/ACS implantation.
  20. Has received any previous exposure to any/all BMP's of either human or animal extraction.
  21. Has a history of allergy to bovine products or a history of anaphylaxis.
  22. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers- Danlos syndrome, or osteogenesis imperfecta).
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

No Contacts or Locations Provided
  More Information

No publications provided

Responsible Party: Medtronic Spinal and Biologics
ClinicalTrials.gov Identifier: NCT01491425     History of Changes
Other Study ID Numbers: C-9803
Study First Received: December 12, 2011
Last Updated: August 1, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Medtronic Spinal and Biologics:
symptomatic degenerative disc disease

Additional relevant MeSH terms:
Spinal Diseases
Intervertebral Disk Degeneration
Bone Diseases
Musculoskeletal Diseases

ClinicalTrials.gov processed this record on July 29, 2014