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Cervical Degenerative Disc DiseaseNCT00637156

Study of the Safety and Effectiveness of the Artificial Cervical Disc - Low Profile Device at Two Adjacent Levels

A study testing PRESTIGE LP device at two adjacent levels and Bi-level fusion with ATLANTIS Cervical Plate System in people with Cervical Degenerative Disc Disease and Radiculopathy, run by Medtronic Spinal and Biologics at 29 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this clinical investigation is to assess the safety and effectiveness of using the PRESTIGE-LP device in the treatment of patients with symptomatic degenerative disc disease at two adjacent levels of the cervical spine, with overall success being the primary endpoint of the clinical trial. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
PRESTIGE LP device at two adjacent levels and Bi-level fusion with ATLANTIS Cervical Plate System
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
397 participants
Where
29 sitesUnited States
Study dates
Jun 2006to 1 Feb 2018
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Has cervical DDD at 2 adjacent cervical levels (C3-C7) requiring surgical treatment \& involving intractable radiculopathy, myelopathy, or both
  • Has a herniated disc and/or osteophyte formation at each level to be treated that is producing symptomatic nerve root and/or spinal cord compression. The condition is documented by patient history, and the requirement for surgical treatment is evidenced by radiographic studies
  • Unresponsive to non-operative treatment for approximately 6 weeks or has the presence of progressive symptoms or signs of nerve root/spinal cord compression in the face of continued non-operative management
  • Has no previous surgical intervention at the involved levels or any subsequent planned/staged surgical procedure at the involved or adjacent level(s)
  • Must be ≥ 18 years; skeletally mature at time of surgery
  • Preoperative NDI score ≥ 30
Show all 9Show fewer
  • Preoperative neck pain score ≥ 8 based on the preoperative Neck and Arm Pain Questionnaire
  • If a female of childbearing potential, patient is non-pregnant, non-nursing, and agrees not to become pregnant during the study period
  • Is willing to comply with the study plan and sign Patient Informed Consent Form

Who cannot join

  • Has a cervical spinal condition other than symptomatic cervical DDD requiring surgical treatment at the involved levels
  • Has documented or diagnosed cervical instability relative to adjacent segments at either level, defined by dynamic (flexion/extension) radiographs showing: Sagittal plane translation > 3.5 mm, or Sagittal plane angulation > 20 degrees.
  • Has more than two cervical levels requiring surgical treatment
  • Has a fused level adjacent to the levels to be treated
  • Has severe pathology of the facet joints of the involved vertebral bodies
  • Has had previous surgical intervention at either one or both of the involved levels or at adjacent levels
Show all 28Show fewer
  • Has been previously diagnosed with osteopenia or osteomalacia
  • Has any of the following that may be associated with a diagnosis of osteoporosis (If "Yes" to any of the below a DEXA Scan will be required to determine eligibility.)
  • Postmenopausal non-Black female over age of 60 who weighs < 140 pounds
  • Postmenopausal female who has sustained a non-traumatic hip, spine, or wrist fracture
  • Male > 70 years
  • Male > 60 years who has sustained a non-traumatic hip or spine fracture
  • If the level of BMD is a T score of -3.5 or lower or a T score of -2.5 or lower with vertebral crush fracture, then the patient is excluded from the study
  • Has presence of spinal metastases
  • Has overt or active bacterial infection, either local or systemic
  • Has insulin dependent diabetes
  • Is a tobacco user who does not agree to suspend smoking prior to surgery
  • Has chronic or acute renal failure or prior history of renal disease
  • Has a documented allergy or intolerance to stainless steel, titanium, or a titanium alloy
  • Is mentally incompetent (If questionable, obtain psychiatric consult)
  • Is a prisoner
  • Is pregnant
  • Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug abuse
  • Is involved with current or pending litigation regarding a spinal condition
  • Has received drugs that may interfere with bone metabolism within two weeks prior to the planned date of spinal surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs
  • Has a history of an endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's Disease, renal osteodystrophy, Ehlers-Danlos Syndrome, or osteogenesis imperfecta)
  • Has a condition that requires postoperative medications that interfere with the stability of the implant, such as steroids. (This does not include low-dose aspirin for prophylactic anticoagulation and routine perioperative anti-inflammatory drugs.)
  • Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following implantation

Trial locations and contacts

29 sites in 1 country.

29 sites in 1 country

United States29 sites
  • Crystal Clinic, Inc.; Akron General Medical Center

    Akron, Ohio, 44333

  • OAA Orthopaedic Specialists

    Allentown, Pennsylvania, 18104

  • Peachtree Neurosurgery, Northside Hospital

    Atlanta, Georgia, 30342

  • Central Texas Spine Institute; Health South Surgical Center

    Austin, Texas, 78731

  • The Center Orthopaedic & Neurosurgical Care & Research

    Bend, Oregon, 97701

  • Todd Lanman, MD, FACS, A Professional Corp.;

    Beverly Hills, California, 90210

  • University at Buffalo Neurosurgery, Inc. Kaleida Health-Buffalo General Medical center/Gates Vascular Institute

    Buffalo, New York, 14203

  • Center for Sports Medicine and Orthopaedics; Memorial Hospital

    Chattanooga, Tennessee, 37404

  • The Orthopedic Center of St. Louis; Barnes Jewish West County Hospital

    Chesterfield, Missouri, 63017

  • Bone & Spine Surgery

    Colton, California, 92324

  • The Hughston Clinic, P.C., Hughston Hospital and Rehabilitation Center

    Columbus, Georgia, 31908

  • Neuro Spine & Pain Center; Lutheran Hospital

    Fort Wayne, Indiana, 46804

  • Great Lakes Neurosurgical; Spectrum Health East Campus

    Grand Rapids, Michigan, 49505

  • The Orthopaedic Center; Crestwood Medical Center

    Huntsville, Alabama, 35801

  • University of Iowa Hospitals & Clinics

    Iowa City, Iowa, 52242

  • East Tennessee Brain & Spine Center, Johnson City Medical Center

    Johnson City, Tennessee, 37604

  • La Jolla Neurological Associates, AMC; Scripps Memorial Hospital La Jolla; Scripps Memorial Hospital Encinitas

    La Jolla, California, 92037

  • Montana Neuro Science Institute; St. Patrick's Medical Center

    Missoula, Montana, 59802

  • West Virginia University; Ruby Memorial Hospital, WVU Hospitals, Inc.

    Morgantown, West Virginia, 26506

  • Delaware Neurosurgical Group; Christiana Care Health Systems

    Newark, Delaware, 19713

  • Spinal Associates, Gulf Coast Hospital

    Panama City, Florida, 32405

  • Allegheny Neurosurgery; Washington Hospital

    Pittsburgh, Pennsylvania, 15212

  • Adams Neurosurgery; Mid Michigan Medical Center

    Saginaw, Michigan, 48604

  • St. Mary's Spine Center; St. Mary's Hospital

    San Francisco, California, 94117

  • Henry Ford Hospital

    West Bloomfield, Michigan, 48322

  • Lexington Brain and Spine Institute

    West Columbia, South Carolina, 29169

  • Buffalo Neurosurgery Group

    West Seneca, New York, 14224

  • Central Ohio Neurological Surgeons; Mt. Carmel East Hospital

    Westerville, Ohio, 43081

  • Virginia Brain and Spine; Winchester Medical Center

    Winchester, Virginia, 22601

Other trials in United States

About this study

Official title: A Prospective, Randomized, Controlled, Multicenter Pivotal Clinical Trial of the Artificial Cervical Disc-LP at Two Levels for Symptomatic Cervical Disc Disease

The purpose of this clinical investigation is to assess the safety and effectiveness of using the PRESTIGE-LP device in the treatment of patients with symptomatic degenerative disc disease at two adjacent levels of the cervical spine, with overall success being the primary endpoint of the clinical trial. The primary objective is to show non-inferiority of the investigational device to the control treatment. If non-inferiority is established, superiority will also be examined as the secondary objective.

Read the detailed description

This clinical investigation is being conducted to evaluate the PRESTIGE-LP device's performance at two adjacent cervical levels (C3-C7) in the treatment of patients with symptomatic degenerative disc disease. One-half of the patients in this randomized pivotal clinical trial will be treated at two adjacent cervical levels with the PRESTIGE-LP device. The remaining patients will receive a bi-level anterior cervical discectomy and fusion with cortical ring allografts and the ATLANTIS Cervical Plate System.

Being tested
PRESTIGE LP device at two adjacent levels, Bi-level fusion with ATLANTIS Cervical Plate System
Keywords
Symptomatic DDD at Two Adjacent Levels of cervical spine
Medical subject headings
Radiculopathy, Spinal Cord Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PRESTIGE LP device at two adjacent levelsDevice

    Also called disc, artificial disc, cervical disc

    PRESTIGE LP is a prosthetic device intended to replace a damaged disc in the cervical spine and intended to act as an intervertebral body spacer rather than a fusion device. It is inserted using an anterior surgical approach.

  • Bi-level fusion with ATLANTIS Cervical Plate SystemDevice

    Also called plate, cervical plate, fusion, cervical fusion

    Bi-level anterior cervical fusion procedure involving cortical ring allograft and the ATLANTIS Cervical Plate System.

Study groups in NCT00637156
Study groupRoleWhat they receive
PRESTIGE LP DeviceExperimentalNot described
Receives: Device: PRESTIGE LP device at two adjacent levels
ATLANTIS Cervical Plate SystemOtherNot described
Receives: Device: Bi-level fusion with ATLANTIS Cervical Plate System

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rate of Overall Success

    Rate of overall success is reported as the percentage of participants who met all of the following criteria:

    1. Postoperative Neck Disability Index (NDI) score improvement of at least a 15-point increase from preoperative;
    2. Maintenance or improvement in neurological status;
    3. No serious adverse event classified as implant associated or implant/surgical procedure associated; and
    4. No additional surgical procedure classified as a "failure."

    Measured: 24 Months

Secondary outcomes (17)
  1. Success Rate of Neck Disability Index

    Success rate of Neck Disability Index is reported as the percentage of participants whose neck disability index score met the following criterion: Pre-treatment Score - Post-treatment Score ≥ 15.

    Measured: 24 months

  2. Success Rate of Neurological Status

    Success rate of neurological status is reported as the percentage of participants who met neurological success defined as maintenance or improvement in all sections (motor, sensory, and reflexes) for the time period evaluated. In order for a section to be considered a success, each element in the section must either remain the same or improve from the time of the preoperative evaluation to the time period evaluated.

    Measured: 24 months

  3. Neck Pain Success Rate

    Numerical rating scales were used to evaluate pain intensity and frequency. The pain score (0 min, 20 max) was derived by adding the numerical rating scores from the pain intensity (0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be.") and frequency scales (0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time"). Neck pain success rate is reported as the percentage of participants whose neck pain improvement met the following criterion: Preoperative Score - Postoperative Score > 0.

    Measured: 24 months

  4. Arm Pain Success Rate

    Numerical rating scales were used to evaluate pain intensity and frequency. The pain score (0 min, 20 max) was derived by adding the numerical rating scores from the pain intensity (0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be.") and frequency scales (0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time"). Arm pain success rate is reported as the percentage of participants whose arm pain improvement met the following criterion: Preoperative Score - Postoperative Score > 0.

    Measured: 24 months

  5. Success Rate of SF-36 PCS

    Success rate of SF-36 Health Survey include two components: the success rate of a physical component summary (PCS) and the success rate of a mental component summary (MCS). The success of SF-36 PCS was defined as: Post Score - Pre Score >= 0. The Success rate of SF-36 PCS is reported as the percentage of the participants who were classified as a success for SF-36 PCS.

    Measured: 24 months

  6. Success Rate of SF-36 MCS

    Success rate of SF-36 Health Survey include two components: the success rate of a physical component summary (PCS) and the success rate of a mental component summary (MCS). The success of SF-36 MCS were defined as: Post Score - Pre Score >= 0. The Success rate of SF-36 MCS is reported as the percentage of the participants who were classified as a success for SF-36 MCS.

    Measured: 24 months

  7. Rate of Disc Height Success

    Disc height was assessed by determining the Functional Spinal Unit (FSU) height. The rate of disc height success is reported as the percentage of participants whose disc height for each level based on either the anterior or posterior measurements met the following criterion: Postoperative Height - 6 Week Postoperative Height >= -2mm

    Measured: 24 months

  8. Gait Success Rate

    Patient's gait was assessed by using Nurick's classification, and indicated either as normal or graded on a scale of 0 to 5. Success was defined as maintenance or improvement in the postoperative status as compared to the preoperative condition: Preoperative Score - Postoperative Score >= 0. The gait success rate is reported as the percentage of participants who had gait success.

    Measured: 24 months

  9. Operative Time

    Operative time was recorded from skin incision to wound closure.

    Measured: Time of operation, an average of 1.7-2.1hrs

  10. Blood Loss

    Measured: During the time of operation, an average of 1.7-2.1 hrs

  11. Hospital Stay

    Measured: From admission to discharge, an average of 1.0-1.5 day

  12. Rate of Secondary Surgery at Index Level

    Secondary surgical procedures at the index level included revisions, removals, supplemental fixations and reoperations. Rate of secondary surgery at index level is reported as percentage of subjects who had secondary surgeries at index level.

    Measured: 24 months

  13. Change of Neck Disability Index Score From Baseline

    The self-administered Neck Disability Index (NDI) Questionnaire was used to assess patient neck pain and ability to function. The NDI scale ranges from 0-100. The best score is 0 (no disability) and worst is 100 (maximum disability). Change of NDI was defined as NDI at 24 month minus NDI at baseline.

    Measured: Baseline and 24 months post-operation

  14. Change of Neck Pain Score From Baseline

    Numerical rating scales were used to evaluate neck pain intensity and frequency. Subjects rated their neck pain intensity on a scale from 0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be." Similarly, subjects recorded their neck pain frequency on a scale from 0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time." The total neck pain score (0 to 20) was the addition of pain intensity and frequency scores. Change of neck pain score was defined as neck pain score at 24 months minus neck pain score at baseline.

    Measured: Baseline and 24 months post-operation

  15. Change of Arm Pain Score From Baseline

    Numerical rating scales were also used to evaluate arm pain intensity and frequency. Subjects rated their arm pain intensity on a scale from 0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be." Similarly, subjects recorded their arm pain frequency on a scale from 0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time." The total arm pain score (0 to 20) was the addition of pain intensity and frequency scores. Change of arm pain score was defined as arm pain score at 24 months minus arm pain score at baseline.

    Measured: Baseline and 24 months post-operation

  16. Change of General Health Status -- SF-36 PCS From Baseline

    The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess general health status. The SF-36 results were summarized into two components, a physical component summary (PCS) and a mental component summary (MCS). The score for PCS was between 0 and 100, with higher scores denoting better quality of life. Change of SF-36 PCS score was defined as PCS score at 24 months minus PCS score at baseline.

    Measured: Baseline and 24 months post-operation

  17. Change of General Health Status -- SF-36 MCS From Baseline

    The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess general health status. The SF-36 results were summarized into two components, a physical component summary (PCS) and a mental component summary (MCS). The score for MCS was between 0 and 100, with higher scores denoting better quality of life. Change of SF-36 MCS score was defined as MCS score at 24 months minus MCS score at baseline.

    Measured: Baseline and 24 months post-operation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Mar 2008 (estimated)
  2. Study startJun 2006
  3. Primary completionJan 2011
  4. Study completion1 Feb 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
397 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00637156
Sponsor's protocol ID
PRESTIGE LP Two Level Study
Status last verified
Oct 2017
First submitted
3 Mar 2008
Last updated
1 May 2018
Data monitoring committee
Yes

Publications

  • Gornet MF, Lanman TH, Burkus JK, Hodges SD, McConnell JR, Dryer RF, Schranck FW, Copay AG. One-Level Versus 2-Level Treatment With Cervical Disc Arthroplasty or Fusion: Outcomes Up to 7 Years. Int J Spine Surg. 2019 Dec 31;13(6):551-560. doi: 10.14444/6076. eCollection 2019 Dec.

    PubMed 31970051
  • Gornet MF, Lanman TH, Burkus JK, Dryer RF, McConnell JR, Hodges SD, Schranck FW. Two-level cervical disc arthroplasty versus anterior cervical discectomy and fusion: 10-year outcomes of a prospective, randomized investigational device exemption clinical trial. J Neurosurg Spine. 2019 Jun 21;31(4):508-518. doi: 10.3171/2019.4.SPINE19157. Print 2019 Oct 1.

    PubMed 31226684
  • Lanman TH, Burkus JK, Dryer RG, Gornet MF, McConnell J, Hodges SD. Long-term clinical and radiographic outcomes of the Prestige LP artificial cervical disc replacement at 2 levels: results from a prospective randomized controlled clinical trial. J Neurosurg Spine. 2017 Jul;27(1):7-19. doi: 10.3171/2016.11.SPINE16746. Epub 2017 Apr 7.

    PubMed 28387616
  • Gornet MF, Lanman TH, Burkus JK, Hodges SD, McConnell JR, Dryer RF, Copay AG, Nian H, Harrell FE Jr. Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. J Neurosurg Spine. 2017 Jun;26(6):653-667. doi: 10.3171/2016.10.SPINE16264. Epub 2017 Mar 17.

    PubMed 28304237

Questions about this trial

What is this clinical trial studying?

A study testing PRESTIGE LP device at two adjacent levels and Bi-level fusion with ATLANTIS Cervical Plate System in people with Cervical Degenerative Disc Disease and Radiculopathy, run by Medtronic Spinal and Biologics at 29 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 May 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Nov 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of Overall Success (time frame: 24 Months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00637156, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 May 2018.

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