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The CSM Trial: A Multicenter Study Comparing Ventral to Dorsal Surgery for Cervical Spondylotic Myelopathy (CSM)

This study has been completed.
Yale University
Information provided by (Responsible Party):
Greenwich Hospital Identifier:
First received: July 24, 2007
Last updated: August 28, 2012
Last verified: August 2012

The purpose of the study is to determine the optimal surgical approach (ventral versus dorsal) for patients with multi-level cervical spondylotic myelopathy (CSM). There are no established guidelines for the management of patients with CSM, which slowly causes spinal cord injury in afflicted patients.

This study aims to test the hypothesis that ventral surgery (decompressing the spinal cord from the front of the neck) and dorsal surgery (decompressing the spinal cord from the back of the neck) might differ in their overall outcome or major complication rate.

Condition Intervention Phase
Cervical Spondylotic Myelopathy
Procedure: Ventral Surgical Decompression with Instrumented Fusion
Procedure: Dorsal Decompression With or Without Fusion
Phase 3

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: The CSM Trial: A Multicenter Study Comparing Ventral to Dorsal Surgery for Cervical Spondylotic Myelopathy

Resource links provided by NLM:

Further study details as provided by Greenwich Hospital:

Primary Outcome Measures:
  • Oswestry Neck Disability Index, mJOA, major complication rate [ Time Frame: 1 year ]

Secondary Outcome Measures:
  • SF-36 physical component summary (PCS), EuroQol-5D [ Time Frame: 1 year ]

Enrollment: 103
Study Start Date: November 2006
Study Completion Date: May 2012
Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: A
Ventral Decompression and Instrumented Fusion
Procedure: Ventral Surgical Decompression with Instrumented Fusion
Multi-level discectomy or Corpectomy are performed at surgeon's discretion. After decompression an instrumented fusion is performed.
Active Comparator: B
Dorsal Decompression with or without fusion
Procedure: Dorsal Decompression With or Without Fusion
Dorsal decompressive laminectomy, laminoplasty, or laminectomy with lateral mass instrumented fusion

  Show Detailed Description


Ages Eligible for Study:   40 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • degenerative cervical spondylotic myelopathy (2 or more levels of spinal cord compression)

Exclusion Criteria:

  • C2-C7 kyphosis>5˚ (measured on lateral cervical spine image in extension)
  • Segmental kyphotic deformity defined as 3 or more levels of disc-osteophyte extend dorsal to a line drawn from the dorsal caudal point of C2 to the dorsal caudal point of C7.
  • Ossification of posterior longitudinal ligament (OPLL)
  • Developmental narrow canal (<12 mm-canal diameter measured on lateral plain cervical spine film)
  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 identifier: NCT00506558

United States, Connecticut
Danbury Hospital
Danbury, Connecticut, United States, 06810
Greenwich Hospital
Greenwich, Connecticut, United States, 06830
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Lahey Clinic
Burlington, Massachusetts, United States, 01805
United States, New Jersey
University of Medicine and Dentistry - New Jersey
Newark, New Jersey, United States, 07103
United States, Ohio
Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
United States, Utah
University of Utah HSC
Salt Lake City, Utah, United States, 84132-2303
Sponsors and Collaborators
Greenwich Hospital
Yale University
Study Director: Zoher Ghogawala, MD, FACS Greenwich Hospital - Yale Universtiy School of Medicine
Principal Investigator: Edward C. Benzel, MD The Cleveland Clinic
Principal Investigator: Robert Heary, MD University of Medicine and Dentistry of New Jersey
Principal Investigator: Ronald Apfelbaum University of Utah
Principal Investigator: Jean-Valery Coumans, MD Massachusetts General Hospital
Principal Investigator: Subu N Magge, MD Lahey Clinic
  More Information

Additional Information:
Responsible Party: Greenwich Hospital Identifier: NCT00506558     History of Changes
Other Study ID Numbers: GH-CSM-382
Study First Received: July 24, 2007
Last Updated: August 28, 2012

Keywords provided by Greenwich Hospital:
cervical spondylotic myelopathy
degenerative cervical spondylosis
spinal fusion

Additional relevant MeSH terms:
Spinal Cord Diseases
Bone Marrow Diseases
Central Nervous System Diseases
Nervous System Diseases
Hematologic Diseases processed this record on May 22, 2017