Trial record 8 of 16 for:    Open Studies | "Kyphosis"

Comparison of Actifuse ABX and Local Bone in Spinal Surgery

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2013 by Ohio State University
Sponsor:
Collaborator:
Baxter Healthcare Corporation
Information provided by (Responsible Party):
Safdar Khan, Ohio State University
ClinicalTrials.gov Identifier:
NCT01852747
First received: April 30, 2013
Last updated: June 6, 2013
Last verified: June 2013
  Purpose

This study is being done to compare people who had a standard of care spinal fusion using part of their local bone graft (a small amount of bone from the region of the spine where the fusion is occurring) to correct an adult spinal deformity and people who will have a standard of care spinal fusion using a mixture of Actifuse ABX® (a market approved bone graft substitute) and a local bone graft (a small amount of bone from the region of the spine where the fusion is occurring). This study will compare the outcomes of both groups to help the Orthopaedic surgeon conducting spinal fusions in the future. Investigators expect that Actifuse ABX® will be as good if not better than just a local bone graft.


Condition Intervention Phase
Scoliosis
Kyphosis
Lordosis
Procedure: Multilevel Spinal fusion with Actifuse ABX®
Phase 4

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Bio-equivalence Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Actifuse ABX and Local Bone Have Comparable Outcomes to Local Bone in Instrumented Multi-Level Adult Spinal Deformity Patients

Resource links provided by NLM:


Further study details as provided by Ohio State University:

Primary Outcome Measures:
  • Decrease patient recovery time [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    The investigators anticipate the Actifuse ABX® will decrease patient recovery time by 1) lowering the amount of autologous bone harvested from the patient and 2) taking advantage of the properties of Actifuse (osteostimulation, resorption rate, etc) that should result in quicker bone fusing and healing.


Estimated Enrollment: 60
Study Start Date: March 2013
Estimated Study Completion Date: March 2016
Estimated Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Multilevel Spinal Fusion w/ Actifuse ABX®
An osteostimulatory,phase pure,porous,silicate substituted calcium phosphate bone graft substitute used during multilevel spinal fusion.
Procedure: Multilevel Spinal fusion with Actifuse ABX®
Multilevel spinal fusion as treatment for adult spinal deformity with Actifuse ABX®. Actifuse ABX® is a silicate substituted calcium phosphate bone void filler intended for orthopedic applications such as a filler for gaps and voids that are not intrinsic to the stability of the bony structure.
No Intervention: Multilevel Spinal Fusion
Multilevel spinal fusion without Actifuse ABX.

Detailed Description:

The current method for posterolateral lumbar fusion surgeries utilizes autograft bone typically derived from the patient's iliac crest. However, complications have been reported concerning the use of iliac crest bone, that include additional healing time due to the secondary surgical site and gait abnormalities. Clinicians are in need of an adequate alternative, and many have begun testing growth factors or synthetic compounds used in conjunction with local bone autografts. Though this avoids the need for a secondary surgical site, synthetic materials are not without their own limitations. These compounds must achieve similar growth and fusion rates as native bone. This study will test the applicability of Actifuse, a synthetic bone graft substitute, in instrumented multi-level adult spinal deformity surgery.

Actifuse is a silicate substituted calcium phosphate. It is osteostimulative, and is a bone void filler intended for orthopedic applications such as a filler for gaps and voids that are not intrinsic to the stability of the bony structure. Actifuse has several features that mimic human bone (amount of silicon, resorption rate, etc). It provides a scaffold for long-term bone healing and is intended to be packed gently into bony voids or gaps of the skeletal system, i.e. extremities, pelvis and spine including use in posterolateral spinal fusion procedures with appropriate stabilizing hardware. These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. The product provides a bone void filler that is resorbed and replaced by native bone during the healing process.

Actifuse accelerates bone growth by combining an interconnected macro- and micro- porous structure with osteostimulative chemistry created through a patented silicate substitution process to attach and stimulate osteoprogenitor cells (OPCs) and mesenchymal stem cells (MSCs). It resists irrigation and can be easily viewed on x-rays to monitor healing. Previous groups have shown that Actifuse is successful in the laboratory as well as in patients; however, previously reported literature has not studied the efficacy of Actifuse in instrumented multi-level adult spinal deformity.

Based on previous literature, investigators expect the Actifuse ABX to successfully fuse to native bone growth and promote fusion as well as an autograft replacement. Potential pitfalls include Actifuse not functioning as well in place of native bone. If this occurs, investigators will conduct revision surgery to ensure proper bone union.

The success of this project could have significant effects for the society at large. It is estimate that over 200,000 arthrodeses are performed each year, and the autologous iliac crest bone graft is often considered the standard of care, therefore these results could improve the outcome of surgery for thousands of patients every year. In addition, it will likely cut down on time the surgeon is in the operating room. It could also speed patient recovery by 1) lowering the amount of autologous bone harvested from the patient, and 2) taking advantage of the properties of Actifuse (osteostimulation, resorption rate, etc) that should result in quicker bone fusing and healing.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient aged 18 to 80
  • Patient received primary diagnosis of adult spinal deformity (with fusion of >2 levels)
  • Patient is a candidate for multi-level posterior lumbar fusion
  • Patients that do not meet any of the exclusion criteria

Exclusion Criteria:

  • Non-English speaker
  • Current Smoker
  • Prisoner
  • Patient with any of the following:

Severe degenerative disease Inflammatory bone disease (e.g. osteomyelitis) Metabolic bone disease Radiation bone therapy Existing acute or chronic infections Abnormal calcium metabolism Hypocalcaemia Severe vascular or neurological disease Cardiovascular disease precluding elective surgery Uncontrolled diabetes Severely impaired renal function Documented renal disease Malignant tumors Pregnant or nursing

  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.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01852747

Contacts
Contact: Beth Wagg, MPH (614) 293-9013 Elizabeth.Sheridan@osumc.edu

Locations
United States, Ohio
The Ohio State University Recruiting
Columbus, Ohio, United States, 43203
Contact: Beth Wagg, MPH    614-293-9013    Elizabeth.Sheridan@osumc.edu   
Contact: Jessica Wiseman    (614) 366-9138    Jessica.Wiseman@osumc.edu   
Principal Investigator: Safdar Khan, MD         
Sponsors and Collaborators
Ohio State University
Baxter Healthcare Corporation
Investigators
Principal Investigator: Safdar Khan, MD Ohio State University
  More Information

Additional Information:
No publications provided

Responsible Party: Safdar Khan, Safdar Khan, MD, Ohio State University
ClinicalTrials.gov Identifier: NCT01852747     History of Changes
Other Study ID Numbers: 2013H0023
Study First Received: April 30, 2013
Last Updated: June 6, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by Ohio State University:
Spinal Deformity
Multilevel
Posterior
Lumbar
Fusion
Levoscoliosis
Dextroscoliosis
Graft

Additional relevant MeSH terms:
Kyphosis
Lordosis
Swayback
Scoliosis
Spinal Curvatures
Spinal Diseases
Bone Diseases
Musculoskeletal Diseases
Deficiency Diseases
Malnutrition
Nutrition Disorders

ClinicalTrials.gov processed this record on August 20, 2014