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Cervical Degenerative Disc DiseasePhase 3NCT00667459

Study of Safety & Effectiveness of PRESTIGE® LP Cervical Disc vs. Anterior Cervical Fusion in Cervical DDD

A Phase 3 study testing PRESTIGE® LP Cervical Disc and ATLANTIS Anterior Cervical Plate in people with Cervical Degenerative Disc Disease, run by Medtronic Spinal and Biologics at 16 sites in United States.

Completed

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

Official record
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Trial summary

The purpose of this clinical trial is to evaluate the safety and effectiveness of the PRESTIGE® LP Cervical Disc as a method of treating patients with symptoms of cervical degenerative disc disease at a single level from C3-C4 to C6-C7. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cervical Degenerative Disc Disease
What is being tested?
PRESTIGE® LP Cervical Disc and ATLANTIS Anterior Cervical Plate
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
280 participants
Where
16 sitesUnited States
Study dates
Jan 2005to Jun 2014
Phase
Phase 3
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 degenerative disc disease as defined as: intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression that is documented by patient history: a) herniated disc; b) osteophyte formation
  • One level requiring surgical treatment
  • C3-C4 disc to C6-C7 disc level involvement
  • Unresponsive to non-operative treatment for six weeks or presence of progressive symptoms or signs of cord compression
  • No previous surgical procedures at the involved level or any planned surgical procedure at the involved or adjacent level.
  • Preop Neck Disability index score ≥ 30
Show all 9Show fewer
  • Preop Neck Pain score of ≥ 20 based on the Preop Neck \& Arm Pain Questionnaire
  • Not pregnant at time of surgery
  • Willing and able to comply with study plan and able to understand and sign patient informed consent

Who cannot join

  • Any other cervical spinal condition requiring surgical treatment at the involved level
  • Documented or diagnosed cervical instability defined by radiographs showing
  • Sagittal plane translation > 3.5mm or
  • Sagittal plane angulation > 20 degrees.
  • More than one cervical level requiring surgery
  • A fused level adjacent to the level to be treated
Show all 29Show fewer
  • Severe pathology of the facet joint of involved bodies
  • Previous surgery at the involved level
  • Previously diagnosed osteopenia or osteomalacia
  • Any of the following that may be associated with an osteoporosis diagnosis (if "Yes" to any of these, a DEXA Scan will be required to determine eligibility)
  • Postmenopausal non-Black female over 60 years of age and weighs less than 140 pounds
  • Postmenopausal female that has sustained a non-traumatic hip, spine, or wrist fracture
  • Male over the age of 70
  • Male over the age of 60 that has sustained a non-traumatic hip or spine fracture.
  • If the level of Bone Mineral Density is a T score of -3.5 or lower or a T score of -2.5 or lower with the vertebral crush fracture, then the patient is excluded.
  • Presence of spinal metastases
  • Overt or active bacterial infection, either local or systemic
  • Severe insulin dependent diabetes
  • Chronic or acute renal failure or history of renal disease
  • Temperature > 101º F oral at surgery
  • Documented allergy to stainless steel, titanium or a titanium alloy
  • Mentally incompetent
  • Is a prisoner
  • Is pregnant
  • Is an alcohol and/or drug abuser
  • Has received drugs which may interfere with bone metabolism within 2 weeks prior to the planned surgery date (steroids, methotrexate), excluding routine preop anti-inflammatories)
  • A history of endocrine or metabolic disorder known to affect osteogenesis
  • A condition that requires postop medications that interfere with the stability of the implant (steroids). This does not include low dose aspirin therapy.
  • Received treatment with an investigational therapy within 28 days prior to surgery or planned for 16 weeks following implantation.

Trial locations and contacts

16 sites in 1 country.

16 sites in 1 country

United States16 sites
  • Emory Orthopaedics and Spine Center

    Atlanta, Georgia, 30329

  • Central Illinois Neuroscience

    Bloomington, Illinois, 61701

  • Indiana Spine

    Carmel, Indiana, 46032

  • Cedar Neurological Surgeons, PC

    Cedar Rapids, Iowa, 52403

  • Clinical Trials for South Carolina

    Charleston, South Carolina, 29406

  • University of Virginia,Neurosurgery Department

    Charlottesville, Virginia, 22908

  • Chattanooga Orthopaedic Group

    Chattanooga, Tennessee, 37404

  • The Orthopaedic Center of St. Louis

    Chesterfield, Missouri, 63017

  • Coeur d'Alene Spine and Brain, PLLC

    Coeur d'Alene, Idaho, 83814

  • The Hughston Clinic, P.C.

    Columbus, Georgia, 31908

  • NeuroSpine Institute, LLC

    Eugene, Oregon, 97401

  • OrthoIndy

    Indianapolis, Indiana, 46260

  • Sports Medicine North

    Peabody, Massachusetts, 01960

  • Brain and Spine Center of Texas, L.L.P.

    Plano, Texas, 75093

  • Springfield Neurological Institute

    Springfield, Missouri, 65804

  • Buffalo Neurosurgery Group

    West Seneca, New York, 14224

Other trials in United States

About this study

Official title: A Prospective, Multicenter, Controlled Clinical Trial of an Artificial Cervical Disc LP at a Single Level for Symptomatic Cervical Disc Disease

The purpose of this clinical trial is to evaluate the safety and effectiveness of the PRESTIGE® LP Cervical Disc as a method of treating patients with symptoms of cervical degenerative disc disease at a single level from C3-C4 to C6-C7.

Read the detailed description

This pivotal clinical trial was conducted to compare treatment data of the investigational implant device,the PRESTIGE® LP Cervical Disc, with a control patient group receiving a plate. The PRESTIGE® LP Cervical Disc devices were implanted using an anterior surgical approach. Data from control patients receiving anterior cervical discectomy and fusion with an ATLANTIS Anterior Cervical Plate from the initial Artificial Cervical Disc study (NCT00642876) were compared as both treatment groups receive single-level surgical treatment from C3-C4 to C6-C7 for symptomatic cervical degenerative disc disease.

Being tested
PRESTIGE® LP Cervical Disc, ATLANTIS Anterior Cervical Plate
Keywords
Cervical Disc

What participants receive

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

  • PRESTIGE® LP Cervical DiscDevice

    Also called PRESTIGE® LP

    The PRESTIGE® LP Cervical Disc was inserted into the intervertebral disc space of the cervical spine using the anterior surgical approach.

  • ATLANTIS Anterior Cervical PlateDevice

    Also called ATLANTIS plate

    Anterior cervical discectomy and fusion with ATLANTIS plate for control group

Study groups in NCT00667459
Study groupRoleWhat they receive
InvestigationalExperimentalPRESTIGE® LP Cervical Disc
Receives: Device: PRESTIGE® LP Cervical Disc
ControlActive comparatorControl patients who received a ACDF fusion treatment from a previous IDE trial (NCT00642876)
Receives: Device: ATLANTIS Anterior Cervical Plate

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 score improvement of at least a 15-points from preoperative;
    2. Maintenance or improvement in neurological status;
    3. Disc height success which was defined as either the anterior or posterior measurements meeting the criteria of "Postoperative Height - 6 Week Postoperative Height ≥ -2mm";
    4. No serious adverse event classified as implant associated or implant/surgical procedure associated; and
    5. No secondary 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: 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 remain the same or improve from the time of the preoperative evaluation to the time period evaluated.

    Measured: 24 months

  3. 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

  4. Neck Pain Success Rate

    Numerical rating scales were used to evaluate pain intensity and frequency. The pain score (0 min, 100 max) was derived by multiplying 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: Preoperative Score - Postoperative Score > 0.

    Measured: 24 months

  5. Arm Pain Success Rate

    Numerical rating scales were used to evaluate pain intensity and frequency. The pain score (0 min, 100 max) was derived by multiplying 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: Preoperative Score - Postoperative Score > 0.

    Measured: 24 months

  6. 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

  7. 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

  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, approximately 1.5 hrs.

  10. Blood Loss

    Measured: During the time of operation, approximately 1.5 hours.

  11. Hospital Stay

    Measured: During the time of hospital stay, average of 1 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 patients who had secondary surgeries at index level.

    Measured: 24 months post-operation

  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. Patients 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, patients 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 to100) was the product 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. Patients 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, patients 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 100) was the product 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 posted28 Apr 2008 (estimated)
  2. Study startJan 2005
  3. Primary completionJan 2008
  4. Study completionJun 2014

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 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
280 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00667459
Sponsor's protocol ID
PRESTIGE® LP Protocol, #P03-03
Status last verified
May 2023
First submitted
24 Apr 2008
Last updated
6 Jun 2023
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, Burkus JK, Shaffrey ME, Schranck FW, Copay AG. Cervical disc arthroplasty: 10-year outcomes of the Prestige LP cervical disc at a single level. J Neurosurg Spine. 2019 May 10;31(3):317-325. doi: 10.3171/2019.2.SPINE1956. Print 2019 Sep 1.

    PubMed 31075769
  • Gornet MF, Burkus JK, Shaffrey ME, Nian H, Harrell FE Jr. Cervical Disc Arthroplasty with Prestige LP Disc Versus Anterior Cervical Discectomy and Fusion: Seven-Year Outcomes. Int J Spine Surg. 2016 Jun 22;10:24. doi: 10.14444/3024. eCollection 2016.

    PubMed 27441182

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing PRESTIGE® LP Cervical Disc and ATLANTIS Anterior Cervical Plate in people with Cervical Degenerative Disc Disease, run by Medtronic Spinal and Biologics at 16 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 29 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 6 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 22 Sep 2014). 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 NCT00667459, which also lists 3 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 6 Jun 2023.

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