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Injury, Spinal CordINSPIRE 2NCT03762655

Study of Probable Benefit of the Neuro-Spinal Scaffold™ in Subjects With Complete Thoracic AIS A Spinal Cord Injury as Compared to Standard of Care

A study testing Neuro-Spinal Scaffold in people with Injury, Spinal Cord, run by InVivo Therapeutics at 16 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a randomized, controlled, single-blind, multicenter, two Arm (Treatment or "Scaffold" Arm; Standard of Care or "Comparator" Arm) of a Neuro-Spinal Scaffold to evaluate whether the Scaffold is safe and demonstrates probable benefit for the treatment of complete T2-T12 spinal cord injury as compared to standard… Read more about this study

Who is it for?
Ages 16 to 70 years
Conditions the study is for
Injury, Spinal Cord
What is being tested?
Neuro-Spinal Scaffold
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
16 sitesUnited States
Study dates
21 May 2019to 31 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

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 16 to 70 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • AIS A classification of traumatic spinal cord injury at T2 - T12 neurological level of injury confirmed by a qualified medical professional
  • Recent injury (must have open spine surgery within 7 days from injury)
  • Injury Severity Score (ISS) ≤ 45 at the time of screening
  • Glasgow Coma Scale, GCS ≥ 14 (GCS ≥ 10 for intubated subjects) at the time of the screening and GCS = 15 (GCS ≥ 10 for intubated subjects) within two hours prior to spine surgery
  • Non-penetrating SCI (contusion injury) that is no less than approximately 4 mm in diameter by MRI
  • Requires open spine surgery allowing access to the injured spinal cord (subjects requiring either posterior surgical approach or posterior plus anterior approach will be eligible)
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  • Informed consent obtained
  • 16-70 years of age, inclusive
  • Eight-hour period of hemodynamically stability (>90 mmHg systolic blood pressure) prior to open spine surgery

Who cannot join

  • Terminally ill subjects not likely to be able to participate in follow-up
  • Incomplete spinal cord injury (AIS B, C, D, and E injuries)
  • Subjects with more than one discrete spinal cord injury
  • No discrete cavity in the contused spinal cord in which a Scaffold can be placed
  • Evidence of clear and significant Somatosensory Evoked Potentials (SSEP) transmission through the injury site (based on the judgment of the Investigator)
  • Subjects with clinically significant pre-existing neurological comorbidities that are unrelated to the contusion being treated (e.g. MS, ALS, significant prior peripheral nerve dysfunction, residual problems related to previous spine-related neurological pathologies) will be excluded only if it is felt that these preexisting morbidities will increase risk, affect safety monitoring, or confound study results
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  • Spinal cord injury associated with significant traumatic brain injury or coma that, in the opinion of the Investigator, would preclude adequate assessment of spinal cord function, brain injury that could be associated on its own with sensory or motor deficits, or subjects with any other reason that results in an unreliable ISNCSCI exam
  • Subjects with clinically significant pre-existing respiratory disease not related to the contusion being treated (e.g., COPD)
  • Subjects requiring long-term ongoing mechanical ventilation
  • Subjects with documented immune deficiency disorders, including a known diagnosis of HIV infection/AIDS
  • Recent (according to DSM IV or DSM V criteria) history of abuse of narcotics or other significant substance abuse
  • Significant injury complications where, in the view of the Investigator, participation in the study could further complicate subject care, limit study follow-up, or confound interpretation of safety or efficacy data.
  • A female who is:
  • Pregnant, or planning to become pregnant within the next 12-months; or
  • Breastfeeding; or
  • A woman of child-bearing potential (defined as post menarche and biologically capable of becoming pregnant [i.e., not surgically sterile]) who is engaged in active heterosexual relations and is not willing to use a barrier or hormonal form of birth control for 12-months following open spine surgery (e.g., oral, injected, or implanted contraceptives)
  • A male who is engaged in active heterosexual relations and is not willing to use birth control for 3-months following open spine surgery including sperm donation or banking
  • Current or impending incarceration
  • Complete spinal cord transection as determined by screening MRI
  • Subjects with spinal cord injuries directly due to gunshot, knife, or other penetrating wounds.
  • Known hypersensitivity to PLGA or PLL (e.g., hypersensitivity to absorbable sutures containing PLGA)
  • History of severe mental illness (according to DSM IV or V)
  • Evidence of pre-trauma active local or systemic infection
  • Participation in another interventional clinical trial for six months after open spine surgery
  • BMI over 39
  • Having a medical condition (e.g., cardiovascular disease, life threatening injuries), or receiving medical treatment, or having any other reason that, in the judgment of the Investigator, precludes successful participation and follow-up for at least six months or confounds collection or interpretation of study safety, feasibility, or efficacy data
  • Subjects receiving tetracyclines, such as minocycline (subjects must discontinue tetracyclines to be enrolled in the study; tetracyclines can be resumed after 6 months post-open spine surgery

Trial locations and contacts

16 sites in 1 country.

16 sites in 1 country

United States16 sites
  • University of Maryland Medical Center

    Baltimore, Maryland, 21201

  • University of Colorado Memorial Hospital Central

    Colorado Springs, Colorado, 80909

  • Elmhurst Hospital Center

    Elmhurst, New York, 11373

  • Vidant Medical Center

    Greenville, North Carolina, 27834

  • University of Iowa

    Iowa City, Iowa, 52242

  • Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10003

  • Rutgers Center for Spine Surgery

    Newark, New Jersey, 07101

  • Penn Presbyterian Medical Center

    Philadelphia, Pennsylvania, 19104

  • Thomas Jefferson University

    Philadelphia, Pennsylvania, 19107

  • University of Pittsburgh Medical Center-Presbyterian

    Pittsburgh, Pennsylvania, 15213

  • Rhode Island Hospital

    Providence, Rhode Island, 02903

  • UC Davis Medical Center

    Sacramento, California, 95817

  • University of Texas Health San Antonio

    San Antonio, Texas, 78229

  • University of California San Diego

    San Diego, California, 92103

  • University of South Florida Health Neurosurgery

    Tampa, Florida, 33613

Other trials in United States

About this study

Official title: Randomized, Controlled, Single-blind Study of Probable Benefit of the Neuro-Spinal Scaffold™ for Safety and Neurologic Recovery in Subjects With Complete Thoracic AIS A Spinal Cord Injury as Compared to Standard of Care

This is a randomized, controlled, single-blind, multicenter, two Arm (Treatment or "Scaffold" Arm; Standard of Care or "Comparator" Arm) of a Neuro-Spinal Scaffold to evaluate whether the Scaffold is safe and demonstrates probable benefit for the treatment of complete T2-T12 spinal cord injury as compared to standard of care open spine surgery.

Read the detailed description

This is a randomized, controlled, single blind, two-arm, multicenter Humanitarian Device Exemption (HDE) study to evaluate the safety and probable benefit of the poly(lactic-co-glycolic acid)-b-poly(L-lysine) Scaffold ("Scaffold") in subjects with thoracic AIS A traumatic spinal cord injury at neurological level of injury of T2-T12 as compared to standard of care open spine surgery. Subjects will be randomized in a blinded manner to one of two study arms, the Treatment or "Scaffold" Arm and the Standard of Care or "Comparator" Arm. Subjects in the Scaffold Arm will have the Scaffold implantation immediately following standard of care open spine surgery. Subjects in the Comparator Arm will have standard of care open spine surgery and will not receive the Scaffold. The subjects will be blinded to their study arm for the duration of the study.

Primary Objective: To evaluate whether the Scaffold is safe and demonstrates probable benefit for the treatment of complete T2-T12 spinal cord injury as compared to standard of care open spine surgery.

Regulatory Objective: To enhance the clinical evidence for the Scaffold in the treatment of complete thoracic spinal cord injuries.

Intended Use: The Scaffold is intended for use in patients age 16-70 years diagnosed with a T2-T12 neurological level of injury functionally complete (AIS A) spinal cord injury for whom open spine surgery, (e.g., laminectomy, spine stabilization) which allows access to the dura of the injured spinal cord, is recommended as an option. The Scaffold is intended to be implanted in a cavity at the epicenter of the spinal cord contusion during open spine surgery. The Scaffold is intended for use in recent (≤7 days) spinal cord injuries that do not involve penetrating injury to the cord or complete severing of the cord.

Being tested
Neuro-Spinal Scaffold
Medical subject headings
Spinal Cord Injuries

What participants receive

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

  • Neuro-Spinal ScaffoldDevice

    The investigational product ("Neuro-Spinal ScaffoldTM" or "Scaffold") is a porous bioresorbable polymer scaffold comprised of a synthetic biomaterial, poly(lactic-co-glycolic acid)-b-poly(L-lysine) (PLGA-PLL). The Scaffold is cylindrical in shape (3 mm diameter) and is available is three lengths (6 mm, 8 mm, 10 mm) for optimal fit in the intraspinal lesion cavity.

    Based upon pre-clinical testing, the Scaffold is expected to be resorbed from the site of implant within 4 to 8 weeks.

Study groups in NCT03762655
Study groupRoleWhat they receive
Neuro-Spinal Scaffold ArmExperimentalSubjects in the Scaffold Arm will have the Scaffold implantation immediately following standard of care open spine surgery.
Receives: Device: Neuro-Spinal Scaffold
Comparator ArmNo interventionSubjects in the Comparator Arm will have standard of care open spine surgery and will not receive the Scaffold.

What is being measured

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

  1. Change in AIS grade of one or more levels

    The proportion of subjects with an improvement of at least one AIS grade will be presented for each study arm.

    The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examinations determine the ASIA Impairment Scale (AIS) grade.

    Measured: 6 months post-implant

Secondary outcomes (10)
  1. Change in Neurological Level of Injury (NLI)

    The ISNCSCI examinations determine the the Neurological Level of Injury (NLI). The NLI refers to the most caudal segment of the spinal cord with normal sensory and antigravity motor function on both sides of the body, provided that there is normal (intact) sensory and motor function rostrally.

    NLI will be summarized for each study arm at visits (pre-surgery, 3-months, 6-months, 12-months, 24-months). Observed values and change from the baseline will be presented for each study arm.The ISNCSCI exam performed within 8 hours prior to surgery (pre-surgery ISNCSCI) will be used as the baseline.

    Measured: 3-months, 6-months, 12-months, 24-months post-open spine surgery

  2. Change in motor scores

    A numerical summary score of motor function in each extremity determined by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. This score can reflect the degree of neurological impairment associated with the SCI, with lower score indicating greater impairment. Score ranges from 0-25 for each extremity, with maximum scores of 50 for the upper limbs and 50 for the lower limbs.

    Motor scores will be summarized for each study arm at visits (pre-surgery, 3-months, 6-months, 12-months, 24-months). Observed values and change from the baseline will be presented for each study arm.The ISNCSCI exam performed within 8 hours prior to surgery (pre-surgery ISNCSCI) will be used as the baseline.

    Measured: 3-months, 6-months, 12-months, 24-months post-open spine surgery

  3. Change in sensory scores

    A numerical summary score of sensory function in each determined by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. This score can reflect the degree of neurological impairment associated with the SCI, with lower score indicating greater impairment. Score ranges from 0-56 points each for light touch and pin prick (sharp/dull discrimination) modalities, with a maximum total score of 112 points per side of the body.

    Observed values and change from the baseline will be presented for each study arm.The ISNCSCI exam performed within 8 hours prior to surgery (pre-surgery ISNCSCI) will be used as the baseline.

    Measured: 3-months, 6-months, 12-months, 24-months post-open spine surgery

  4. Changes in bladder, bowel, and sexual function

    Bladder, bowel and sexual function will be assessed using the Lower Urinary Tract, Bowel and Sexual Function System/Organ section of the ASIA Autonomic Standards Assessment Form. The Autonomic Standards Assessment Form has three questions in each category (Lower Urinary Tract or bladder, Bowel, Sexual Function) and each question is scored on a scale from 0 (complete loss of control) - 2 (normal function). Observed values and change from baseline will be presented for each study arm. The hospital discharge visit will be used as the baseline visit.

    Measured: 6-months, 12-months and 24-months, post-open spine surgery

  5. Changes in spinal cord dimension

    Spinal cord dimensions (above, at, and below level of injury) will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

  6. Changes in spinal cord lesion size

    Lesion size (in mm) will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

  7. Changes in spinal cord lesion location

    Lesion Location will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

  8. Changes in spinal cord anatomy-Presence of cyst

    Cyst presence or absence will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

  9. Changes in cyst size, if present

    Cyst size, if present, will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

  10. Changes in cyst location, if present

    Cyst location, if present, will be assessed by an independent board-certified neuroradiologist central reader. Observed values and change from baseline will be presented for each study arm. The Screening MRI will be used as the baseline.

    Measured: 72-hours, 3-months, 6-months, 12-months, and 24-months post-open spine surgery

Timeline

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

  1. First posted4 Dec 2018
  2. Study start21 May 2019
  3. Primary completion9 Mar 2023
  4. Study completion31 Dec 2023

Why it stopped: Primary Endpoint not met

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
Model description
Subjects will be randomized in a blinded manner to one of two study arms, the Treatment or "Scaffold" Arm and the Standard of Care or "Comparator" Arm. Subjects in the Scaffold Arm will have the Scaffold implantation immediately following standard of care open spine surgery. Subjects in the Comparator Arm will have standard of care open spine surgery and will not receive the Scaffold.
Masking
Single blind
Who is masked
Participant
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03762655
Sponsor's protocol ID
InVivo-100-105
Acronym
INSPIRE 2
Status last verified
Jun 2022
First submitted
29 Nov 2018
Last updated
17 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • Harrop JS, Kim KD, Okonkwo DO, Goldstein IM, Lee KS, Toselli RM. Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: A Randomized Controlled Trial (INSPIRE 2.0). Neurosurgery. 2025 Apr 1;96(4):751-762. doi: 10.1227/neu.0000000000003180. Epub 2024 Oct 8.

    PubMed 39471088

Questions about this trial

What is this clinical trial studying?

A study testing Neuro-Spinal Scaffold in people with Injury, Spinal Cord, run by InVivo Therapeutics 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 27 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: stopped early, as of the sponsor's last update on 17 Jan 2024. 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.

Are results available for this study?

The study was stopped early (reason given: Primary Endpoint not met). Results are not available in the source record.

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?

Change in AIS grade of one or more levels (time frame: 6 months post-implant). 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 NCT03762655, which also lists 1 linked publication.

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 17 Jan 2024.

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