MIS ReFRESH: Robotic vs. Freehand Minimally Invasive Spinal Surgeries

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2016 by Mazor Robotics
Information provided by (Responsible Party):
Mazor Robotics
ClinicalTrials.gov Identifier:
First received: February 5, 2014
Last updated: March 20, 2016
Last verified: March 2016
To quantify potential short- and long-term benefits of robotically-guided minimally invasive spine surgery (MIS) for adult patients with lower back degeneration, in comparison a matching group of control patients operated in a minimally invasive approach whether freehand or with image guidance or navigation techniques.

Degenerative Spine Disease

Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: Multi-center, Partially Randomized, Controlled Trial of MIS Robotic vs. Freehand in Short Adult Degenerative Spinal Fusion Surgeries

Further study details as provided by Mazor Robotics:

Primary Outcome Measures:
  • Intra-operative exposure to x-ray radiation [ Time Frame: Day of surgery ] [ Designated as safety issue: No ]
    Reading of exposure in seconds (and KvP if available) from C-arm or other imaging system used in the operating room.

  • Surgical complications [ Time Frame: Within first year from day of surgery ] [ Designated as safety issue: No ]
    New neural deficits, implant-related durotomy, infection requiring return to surgery, hardware failure requiring removal, vertebral body fracture, failure to fuse

  • Revision surgeries [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    All cause revisions

Secondary Outcome Measures:
  • Pedicle screw instrumentation accuracy [ Time Frame: Within 1 year of surgery, if indicated by surgeon and clinically necessary ] [ Designated as safety issue: No ]
    Accuracy will be quantified in millimeters and scored using the Gertzbein-Robbins classification, based on postoperative CTs that are clinically necessary for the management of the patient.

  • Incidence of pseudoarthrosis (malunion) [ Time Frame: Within 10 years from surgery ] [ Designated as safety issue: No ]
    Failure of the operated spinal segment to fuse.

  • Length of convalescence [ Time Frame: Within 2 years of surgery ] [ Designated as safety issue: No ]
    Length of stay at the hospital, destination at discharge, time to return to normal activities, time to return to work

  • Times of intra-operative stages [ Time Frame: Day of surgery ] [ Designated as safety issue: No ]
    instrumentation time per screw, total surgery time

  • Ratio of executed vs. planned screws [ Time Frame: Day of surgery ] [ Designated as safety issue: No ]
    number of screws planned to be robotically inserted and manually inserted instead and cause.

  • Quality of life assessment [ Time Frame: Each visit up to 10 years ] [ Designated as safety issue: No ]
    Health related quality of life questionnaires, including: back and leg Visual Analog Scale (VAS), Oswestry Disability Index (ODI), European Quality % Dimensions (EQ-5D-5L)

Estimated Enrollment: 2000
Study Start Date: October 2014
Estimated Study Completion Date: March 2027
Estimated Primary Completion Date: October 2017 (Final data collection date for primary outcome measure)
Adult patients (21 years or older) undergoing short (4 or less consecutive vertebrae) thoracic, lumbar or lumbosacral percutaneous/minimally invasive robotic-guided spinal fixation surgery.
Freehand image-guided
Adult patients (21 years or older) undergoing short (4 or less consecutive vertebrae) thoracic, lumbar or lumbosacral percutaneous/minimally invasive image-guided freehand or navigated spinal fixation surgery.


Ages Eligible for Study:   21 Years to 99 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Adult patients (21 years or older) undergoing short (4 or less consecutive vertebrae) thoracic, lumbar or lumbosacral percutaneous/minimally invasive spinal fixation sugery.

Inclusion Criteria:

  1. Adult patients (age over 21 years), undergoing short (4 or less consecutive vertebrae) lumbar or lumbosacral percutaneous/MIS spinal fixation surgery.
  2. May include surgeries involving iliac screws, although these screws will not be included in the data analysis.
  3. Primary fusion surgery
  4. Patient capable of complying with study requirements
  5. Signed informed consent by patient

Exclusion Criteria:

  1. Pregnancy
  2. Revision surgery (prior laminectomy or discectomy is not excluded).
  3. Infection or malignancy
  4. Primary abnormalities of bones (e.g. osteogenesis imperfecta)
  5. Primary muscle diseases, such as muscular dystrophy
  6. Neurologic diseases (e.g. Charcot-Marie Tooth, Guillain-Barre syndrome, cerebral palsy, spina bifida or neurofibroma)
  7. Spinal cord abnormalities with any neurologic symptoms or signs
  8. Spinal cord lesions requiring neurosurgical interventions, such as hydromyelia
  9. Paraplegia
  10. Patients who have participated in a research study involving an investigational product in the 12 weeks prior to surgery
  11. Patients requiring anterior release or instrumentation
  12. Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the study, or may influence the result of the study.
  13. Patient cannot follow study protocol, for any reason
  14. Patient cannot or will not sign informed consent
  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: NCT02057744

Contact: Doron Dinstein, MD (800) 80 - MAZOR clinicalstudy@mazorrobotics.com
Contact: Sara L Rivera, BS 3212460223 s.rivera@mazorrobotics-us.com

United States, Florida
Florida Hospital Celebration Health Recruiting
Celebration, Florida, United States
Contact: Sylvia Hercules    407-303-4556      
Principal Investigator: Faissal Zahrawi, MD         
The Spine Institute on the Emerald Coast Not yet recruiting
Destin, Florida, United States, 32541
Contact: Sara L Rivera, BS    321-246-0223    s.rivera@mazorrobotics-us.com   
Principal Investigator: Kornelis A Poelstra, MD, Ph. D         
Baptist Health Recruiting
Jacksonville, Florida, United States
Contact: Barbara P Hurlbert    904-388-6518    bhurlbert@lyerlyneuro.com   
Principal Investigator: Andrew F Cannestra, MD, PhD         
University of Miami Recruiting
Miami, Florida, United States, 33136
Contact: Brenda Boyer    305-243-2361    b.boyer@med.miami.edu   
Principal Investigator: Michael Y Wang, MD         
Southeastern Spine Center & Research Institute Not yet recruiting
Sarasota, Florida, United States, 34232
Contact: Debbie Sobering    901-371-9773    dsobering@southeasternspinecenter.com   
Principal Investigator: Thomas M Sweeney, MD         
Sub-Investigator: Tan Duy Ly, DO         
United States, Georgia
Chatham Orthopaedic, PA Recruiting
Savannah, Georgia, United States, 31405
Contact: Timothy Czarnecki    912-525-2069    TCzarnecki@chathamortho.com   
Principal Investigator: Raphael R Roybal, MD         
United States, Michigan
Michigan Orthopaedic Spine Surgeons Recruiting
Rochester Hills, Michigan, United States, 48307
Contact: Cecile Pestano, RN    248-215-8080    moss.clinicalresearch@gmail.com   
Principal Investigator: Richard Easton, MD         
Sub-Investigator: Nicholas Papakonstantinuo, MD         
Sub-Investigator: Brady Vibert, MD         
United States, Tennessee
Tabor Orthopedics Recruiting
Memphis, Tennessee, United States, 38116
Contact: Samuel R Schroerlucke, MD    901-767-8662      
Principal Investigator: Samuel R Schroerlucke, MD         
United States, Virginia
Virginia Spine Institute Recruiting
Reston, Virginia, United States
Contact: Carrie Califano    703-709-1114    ccalifano@spinerf.org   
Principal Investigator: Christopher R Good, MD         
Sponsors and Collaborators
Mazor Robotics
Study Director: Doron Dinstein, MD Mazor Robotics, Ltd
  More Information

Responsible Party: Mazor Robotics
ClinicalTrials.gov Identifier: NCT02057744     History of Changes
Other Study ID Numbers: CLN110 
Study First Received: February 5, 2014
Last Updated: March 20, 2016
Health Authority: United States: Institutional Review Board

Keywords provided by Mazor Robotics:
Robotic-guided surgery
Minimally invasive spinal surgery
Spinal fusion
Pedicle screws

Additional relevant MeSH terms:
Spinal Diseases
Bone Diseases
Musculoskeletal Diseases

ClinicalTrials.gov processed this record on May 26, 2016