Neuromuscular ScoliosisBiPOWRNCT04021784
Limited-efficacy Testing of SDS and NEMOST for Early Onset Neuromuscular Scoliosis
A study testing SDS and NEMOST in people with Neuromuscular Scoliosis and Distraction System, run by UMC Utrecht at 3 sites in Netherlands.
Trial summary
The primary aim of this study is to investigate and describe the limited efficacy of the Spring Distraction System (SDS) and Bilateral One Way Rod (NEMOST) in maintaining curve reduction without repeat lengthening procedures and complications. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Neuromuscular Scoliosis, Distraction System, Growth Friendly System
- What is being tested?
- SDS and NEMOST
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 28 participants
- Where
- 3 sitesNetherlands
- Study dates
- 6 May 2019to 13 Mar 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 Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Non ambulant
- Neuromuscular or syndromal scoliosis
- Progressive scoliosis indicated for bipolar fixation extending to the pelvis
- Diagnosis of scoliosis before age 10
- Patient under 12 and open triradiate cartilage (usually closes around 12 years for girls and 14 years for boys)
- Main curve proximal end vertebra below Th 3
- Non rigid curve
- Patients who have an indication for a primary surgery
Who cannot join
- Ambulant
- Patients with closed triradiate cartilage
- Patients with a skeletal dysplasia that effects growth (Achondroplasia, SED)
- Patients with a systemic disease which severely influences bone quality e.g. osteogenesis imperfecta, metabolic diseases
- Patients with soft tissue weakness (Ehler Danlos, Marfan, Neurofibromatosis, Prader Willi)
- Patients that have a congenital anomaly of the spine of more than 5 vertebrae
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- Patients with an active systemic disease such as JIA, HIV, oncologic treatment
- Patients with a previous surgical fusion of the spine
- Patients that are expected to be lost to FU due to e.g. likely to immigrate within 1 year.
- Patients that have had a previous spine surgery.
Trial locations and contacts
3 sites in 1 country.
Netherlands3 sites
Amsterdam UMC
Amsterdam, North Holland, 1105AZ
Erasmus Medical Center
Rotterdam
UMC Utrecht
Utrecht, 3584CX
About this study
Official title: Limited-efficacy Testing of Spring Distraction System (SDS) and a Bilateral One Way Rod (NEMOST) for Early Onset Neuromuscular Scoliosis (BiPOWR)
The primary aim of this study is to investigate and describe the limited efficacy of the Spring Distraction System (SDS) and Bilateral One Way Rod (NEMOST) in maintaining curve reduction without repeat lengthening procedures and complications.
Secondary aims are to describe growth of the instrumented spine, health-related quality of life, and to compare both devices.
Read the detailed description
Several innovative solutions have been developed to treat growing children with a severe scoliosis. One device (SDS) was developed internally at the department of orthopaedics UMC Utrecht in the Netherlands. The other device (NEMOST) was developed at the Necker Hospital in France.
This study is designed as a multicenter, limited-efficacy study using two prospective cohorts according a randomised clinical trial. The study will be performed in two centers (UMC Utrecht, Amsterdam UMC and Erasmus MC).
Primary endpoints are the limited-efficacy in terms of maintenance of curve correction and occurrence of SAEs related to the procedure. These data will be compared to a recently described cohort of patients that received a "standard treatment", the MGCR (Skov et al., 2017). Secondary endpoints include spinal- and implant growth, patient performance based on the EOSQ 24 questionnaire and surgical parameters.
- Being tested
- SDS, NEMOST
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SDSDevice
The patient is implanted with SDS.
NEMOSTDevice
The patient is implanted with NEMOST.
| Study group | Role | What they receive |
|---|---|---|
| Spring Distraction System (SDS) | Experimental | The SDS will be placed and fits around a standard rod of 5.5mm. Receives: Device: SDS |
| Necker Enfants Malade OSTeosynthesis (NEMOST) | Experimental | The NEMOST is a one-way-rod that uses a ratchet type of locking mechanism. Both NEMOST devices should be placed in parallel, on the two fixator rods that are connected with a cross connector Receives: Device: NEMOST |
What is being measured
The primary outcome is the main question the study is designed to answer.
Limited-efficacy of SDS and NEMOST in terms of curve correction maintenance
Changes in cobb angle on radiographs post-op and at 4 weeks, 3 months, 6 months and 12 months follow-up (FU). A maximum of 5 degrees increase will be the threshold to define maintenance.
Measured: Until 1 year post-operatively
Incidence of possible Treatment-Emergent Serious Adverse Events of SDS and NEMOST
Reported treatment related Serious Adverse Events (SAEs) per-operatively and at 4 weeks, 3 months, 6 months and 12 months FU.
Measured: Until 1 year post-operatively
Secondary outcomes (12)
Limited-efficacy of SDS and NEMOST in terms of spinal length
Changes in length of T1-T12, T1-S1 and the instrumented segment in mm on calibrated Anterior Posterior (AP) X-rays post-op and at 4 weeks, 3 months, 6 months and 12 months FU.
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to limited-efficacy in terms of curve correction maintenance
Changes in cobb angle on radiographs post-op and at 4 weeks, 3 months, 6 months and 12 months follow-up (FU). A maximum of 5 degrees increase will be the threshold to define maintenance.
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to limited-efficacy in terms of spinal length
Changes in length of T1-T12, T1-S1 and the instrumented segment in mm on calibrated AP X-rays post-op and at 4 weeks, 3 months, 6 months and 12 months FU.
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to the development of the sagittale profile and instrumented thoracic kyphosis
Changes in sagittal profile and thoracic kyphosis and the instrumented (T1 pelvic angle, TPA) segment in mm on calibrated Anterior Posterior (AP) X-rays post-op and at 4 weeks, 3 months, 6 months and 12 months FU.
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to surgery time
Surgery time in minutes
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to blood loss during surgery
Blood loss in cc
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to length of hospital stay
Length of hospital stay in days
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to recovery time
Recovery time in minutes
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to the incidence of disease- or treatment-related Serious Adverse Events
Reported treatment related SAEs per-operatively and at 4 weeks, 3 months, 6 months and 12 months FU.
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to 3D development of the spine
Apical Vertebral Rotation based on bone MRI
Measured: Pre-operatively
SDS vs. NEMOST with respect to Quality Of Life (QOL) on the Early Onset Scoliosis Questionnaires (EOSQ-24)
Parent reported QOL and performance is assessed with the 24-item Early Onset Scoliosis Questionnaires (EOSQ-24) pre-op and at 4 weeks, 3 months, 6 months and 12 months FU. EOSQ-24 covers the following domains: Child's Health Related Quality of Life (16 items), Family Impact (2 items) and Satisfaction (2 items).
Measured: Until 1 year post-operatively
SDS vs. NEMOST with respect to the effect on the development of the pelvic obliquity
Changes in pelvic obliquity on X-rays
Measured: Until 1 year post-operatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jul 2019
- Study start6 May 2019
- Primary completion13 Mar 2023
- Study completion13 Mar 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Neuromuscular ScoliosisStudies of the same condition, open and under way.
- More trials run by UMC UtrechtThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Half of the patients will be implanted with SDS system, the other half will be implanted with NEMOST.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 28 participants (actual)
Sponsor and investigators
- Lead sponsor
- UMC Utrecht
- Sponsor type
- University, hospital or other
- Collaborators
- EUROS
- Responsible party
- Principal investigator, M.C. Kruyt, MD, PhD, UMC Utrecht
- Investigators
- Moyo C Kruyt, MD, PhD, Principal investigator, UMC Utrecht
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04021784
- Sponsor's protocol ID
- NL 64018.041.17
- Acronym
- BiPOWR
- Status last verified
- Jun 2023
- First submitted
- 13 Jun 2019
- Last updated
- 5 Jun 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Tabeling CS, Blaauw IE, Stempels HW, Schlosser TPC, Ito K, Castelein RM, Kruyt MC, Lemans JVC. Efficacy of the spring distraction system for different etiologies of early onset scoliosis: evaluating an evolving treatment concept. Spine Deform. 2026 Jun 2. doi: 10.1007/s43390-026-01368-0. Online ahead of print.
PubMed 42228283Lemans JVC, Tabeling CS, Scholten EP, Stempels HW, Miladi L, Castelein RM, Kruyt MC. Surgical treatment of neuromuscular Early Onset Scoliosis with a bilateral posterior one-way rod compared to the Spring Distraction System: study protocol for a limited-efficacy Randomized Controlled Trial (BiPOWR). BMC Musculoskelet Disord. 2023 Jan 10;24(1):20. doi: 10.1186/s12891-022-06048-4.
PubMed 36627616
Study at a glance
From the registry record, last updated by the sponsor on 5 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Limited-efficacy Testing of Spring Distraction System (SDS) and a Bilateral One Way Rod (NEMOST) for Early Onset Neuromuscular Scoliosis (BiPOWR)
- ClinicalTrials.gov ID
- NCT04021784
- Acronym / sponsor ID
- BiPOWR / NL 64018.041.17
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 28 participants (actual)
- Lead sponsor
- UMC UtrechtUniversity, hospital or other
- Collaborators
- EUROS
- Study start
- 6 May 2019 (actual)
- Primary completion
- 13 Mar 2023 (actual)
- Study completion
- 13 Mar 2023 (actual)
- First posted
- 16 Jul 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary aim of this study is to investigate and describe the limited efficacy of the Spring Distraction System (SDS) and Bilateral One Way Rod (NEMOST) in maintaining curve reduction without repeat lengthening procedures and complications.
Secondary aims are to describe growth of the instrumented spine, health-related quality of life, and to compare both devices.
Detailed description
Several innovative solutions have been developed to treat growing children with a severe scoliosis. One device (SDS) was developed internally at the department of orthopaedics UMC Utrecht in the Netherlands. The other device (NEMOST) was developed at the Necker Hospital in France.
This study is designed as a multicenter, limited-efficacy study using two prospective cohorts according a randomised clinical trial. The study will be performed in two centers (UMC Utrecht, Amsterdam UMC and Erasmus MC).
Primary endpoints are the limited-efficacy in terms of maintenance of curve correction and occurrence of SAEs related to the procedure. These data will be compared to a recently described cohort of patients that received a "standard treatment", the MGCR (Skov et al., 2017). Secondary endpoints include spinal- and implant growth, patient performance based on the EOSQ 24 questionnaire and surgical parameters.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Half of the patients will be implanted with SDS system, the other half will be implanted with NEMOST.
| Arm | Type | Receives |
|---|---|---|
| Spring Distraction System (SDS) | Experimental | Device: SDSThe SDS will be placed and fits around a standard rod of 5.5mm. |
| Necker Enfants Malade OSTeosynthesis (NEMOST) | Experimental | Device: NEMOSTThe NEMOST is a one-way-rod that uses a ratchet type of locking mechanism. Both NEMOST devices should be placed in parallel, on the two fixator rods that are connected with a cross connector |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (8 listed)
- Non ambulant
- Neuromuscular or syndromal scoliosis
- Progressive scoliosis indicated for bipolar fixation extending to the pelvis
- Diagnosis of scoliosis before age 10
- Patient under 12 and open triradiate cartilage (usually closes around 12 years for girls and 14 years for boys)
Key exclusion criteria (10 listed)
- Ambulant
- Patients with closed triradiate cartilage
- Patients with a skeletal dysplasia that effects growth (Achondroplasia, SED)
- Patients with a systemic disease which severely influences bone quality e.g. osteogenesis imperfecta, metabolic diseases
- Patients with soft tissue weakness (Ehler Danlos, Marfan, Neurofibromatosis, Prader Willi)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SDSThe patient is implanted with SDS. | Device | Spring Distraction System (SDS) |
| NEMOSTThe patient is implanted with NEMOST. | Device | Necker Enfants Malade OSTeosynthesis (NEMOST) |
Primary outcome
Limited-efficacy of SDS and NEMOST in terms of curve correction maintenance
Time frame: Until 1 year post-operatively
Changes in cobb angle on radiographs post-op and at 4 weeks, 3 months, 6 months and 12 months follow-up (FU). A maximum of 5 degrees increase will be the threshold to define maintenance.
Incidence of possible Treatment-Emergent Serious Adverse Events of SDS and NEMOST
Time frame: Until 1 year post-operatively
Reported treatment related Serious Adverse Events (SAEs) per-operatively and at 4 weeks, 3 months, 6 months and 12 months FU.
12 secondary outcomes
Limited-efficacy of SDS and NEMOST in terms of spinal length
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to limited-efficacy in terms of curve correction maintenance
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to limited-efficacy in terms of spinal length
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to the development of the sagittale profile and instrumented thoracic kyphosis
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to surgery time
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to blood loss during surgery
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to length of hospital stay
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to recovery time
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to the incidence of disease- or treatment-related Serious Adverse Events
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to 3D development of the spine
Time frame: Pre-operatively
SDS vs. NEMOST with respect to Quality Of Life (QOL) on the Early Onset Scoliosis Questionnaires (EOSQ-24)
Time frame: Until 1 year post-operatively
SDS vs. NEMOST with respect to the effect on the development of the pelvic obliquity
Time frame: Until 1 year post-operatively
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jun 2023.
- Derived from this study: PubMed 42228283Tabeling CS, Blaauw IE, Stempels HW, Schlosser TPC, Ito K, Castelein RM, Kruyt MC, Lemans JVC. Efficacy of the spring distraction system for different etiologies of early onset scoliosis: evaluating an evolving treatment concept. Spine Deform. 2026 Jun 2. doi: 10.1007/s43390-026-01368-0. Online ahead of print.
- Derived from this study: PubMed 36627616Lemans JVC, Tabeling CS, Scholten EP, Stempels HW, Miladi L, Castelein RM, Kruyt MC. Surgical treatment of neuromuscular Early Onset Scoliosis with a bilateral posterior one-way rod compared to the Spring Distraction System: study protocol for a limited-efficacy Randomized Controlled Trial (BiPOWR). BMC Musculoskelet Disord. 2023 Jan 10;24(1):20. doi: 10.1186/s12891-022-06048-4.
- Surgical treatment of neuromuscular Early Onset Scoliosis with a bilateral posterior one-way rod compared to the Spring Distraction System: study protocol for a limited-efficacy Randomized Controlled Trial (BiPOWR)Link provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Moyo C Kruyt, MD, PhD principal investigator
UMC Utrecht
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing SDS and NEMOST in people with Neuromuscular Scoliosis and Distraction System, run by UMC Utrecht at 3 sites in Netherlands.
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 8 inclusion and 10 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 5 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 3 sites in Netherlands. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Limited-efficacy of SDS and NEMOST in terms of curve correction maintenance (time frame: Until 1 year post-operatively). The study lists 2 primary outcomes in all. 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 NCT04021784, which also lists 2 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 5 Jun 2023.