AzTrials
AzTrials

Adolescent Idiopathic ScoliosisNCT05860673

Minimally Invasive Surgery vs Standard Posterior Approach in the Treatment of Developmental Idiopathic Scoliosis

A study testing mini invasive scoliosis surgery and posterior spinal fusion technique in people with Adolescent Idiopathic Scoliosis, run by Istituto Ortopedico Rizzoli at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a randomized trial with 1:1 allocation. The aim of the study is to evaluate clinical and radiographic outcomes in patients with developmental age idiopathic scoliosis treated with mini invasive scoliosis surgery (MIS) technique versus posterior spinal fusion (PSF) technique through clinical and radiographic… Read more about this study

Who is it for?
Ages 12 to 25 years
Conditions the study is for
Adolescent Idiopathic Scoliosis
What is being tested?
mini invasive scoliosis surgery and posterior spinal fusion technique
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
126 participants
Where
1 siteItaly
Study dates
15 Jul 2023to Jun 2032
Phase
Interventional
Are there results?
Not yet: the study is under way

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 12 to 25 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Patients with AIS
  • Age between 12 and 25 years;
  • Site of scoliotic curve: thoracic and/or lumbar;
  • Preoperative radiographic range of the main scoliotic curve between 40° and 70° according to Cobb;
  • Ability and consent of patients/parents to actively participate in the study and clinical follow-up.

Who cannot join

  • Patients already treated surgically for scoliosis;
  • Site of the scoliotic curve: cervical;
  • Patients with scoliosis other than adolescent idiopathic scoliosis;
  • Patients who do not fall within the described parameters;
  • Unbalanced sagittal profile;
  • Patients unable to consent or perform follow-ups.
  • Pregnant women.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Alessandro Gasbarrini, MD contact

6366528 ext. 051

alessandro.gasbarrini@ior.it

Bruna Maccaferri, MD contact

6366567 ext. 051

bruna.maccaferri@ior.it

Italy1 site, 1 recruiting
  • Istituto Ortopedico Rizzoli

    Bologna, 40136

    Alessandro Gasbarrini, MD, alessandro.gasbarrini@ior.it

    Bruna Maccaferri, MD, bruna.maccaferri@ior.it

    Recruiting

Other trials in Italy

About this study

Official title: Minimally Invasive Surgery vs Standard Posterior Approach in the Treatment of Developmental Idiopathic Scoliosis: Randomized Trial.

This is a randomized trial with 1:1 allocation. The aim of the study is to evaluate clinical and radiographic outcomes in patients with developmental age idiopathic scoliosis treated with mini invasive scoliosis surgery (MIS) technique versus posterior spinal fusion (PSF) technique through clinical and radiographic evaluations.

Read the detailed description

Patients with developmental age idiopathic scoliosis will be included in a randomized trial in which one group of patients will be treated with mini invasive scoliosis surgery technique , and one group will be treated instead with traditional posterior spinal fusion arthrodesis. The study design involves a noninferiority evaluation, assuming that MIS does not produce inferior results to the classic technique from the point of view of curve correction. This result would be important, because with equal curve correction success, the risk/benefit balance for minimally invasive surgery is superior, as it reduces the risk of transfusion and postoperative pain. The results of this study could therefore give important guidance for surgeons on choosing the optimal treatment for patients.

Patients will be evaluated by clinical examination, before the surgical procedure and at subsequent follow-ups as per clinical practice: at 2, 6, 12, 24, 60 months after treatment by medical personnel.

During the selection visit, patients will also be evaluated with radiographic examination for measurements necessary to decide the indication for surgical treatment. The patient also undergoes postoperative radiographic examination before discharge, as well as at follow-ups at 2, 6, 12, 24, and 60 months.

Being tested
mini invasive scoliosis surgery, posterior spinal fusion technique
Keywords
posterior spinal fusion, mini invasive scoliosis surgery, Adolescent Idiopathic Scoliosis, randomized trial

What participants receive

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

  • mini invasive scoliosis surgeryProcedure or surgery

    The minimally invasive technique, involves two small median skin incisions that allow the deep structures to be exposed. The muscle fibers are separated from the bony insertion by the process of subperiosteal "skeletonization." The Investigators then proceed with the arthrectomy of the levels to be instrumented and the infiltration of pedicle screw pairs of the appropriate caliber according to the "free-hand" technique. After amplioscopic control of proper screw placement, osteotomies of the posterior elements are performed to facilitate correction of the metameres.

  • posterior spinal fusion techniqueProcedure or surgery

    The standard open technique involves a longitudinal incision along the midline extended along the entire thoracolumbar spine, the paravertebral muscles are incised and spread apart to expose the posterior vertebral structures, in a stretch extending more than 30 cm. The series of facetectomies are performed first, and then pairs of pedicle screws are infixed freehand.

    After performing the osteotomies necessary to mobilize the vertebral metameres at the apex of the deformity, correction by derotation maneuvers is continued, and the obtained correction is fixed with pre-shaped bars that are then connected to the screws and tightened to the nuts by dynamometric technique. Almost all vertebral levels of the thoracolumbar tract are included in the arthrodesis

Study groups in NCT05860673
Study groupRoleWhat they receive
mini invasive scoliosis surgery (MIS)ExperimentalThis technique involves making small, noncontiguous, midline skin incisions at the levels to be instrumented, usually proximal and distal to the area of arthrodesis. A median fascial incision is then made to expose the vertebral segments on which to thread the screws while the bar is inserted submuscularly in a cranio-caudal direction, after appropriate maneuvers to correct the deformity.
Receives: Procedure: mini invasive scoliosis surgery
posterior spinal fusion technique (PSF)Active comparatorThis technique is the surgical gold standard. It consists of an instrumented arthrodesis with posterior access and requires a wide median incision with extensive muscle dissection.
Receives: Procedure: posterior spinal fusion technique

What is being measured

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

  1. Cobb angle measurement

    Cobb's angle represents the gold standard for measuring the extent of the scoliotic curve; it is identified as the angle between the two lines passing through the upper limiting vertebra and the lower limiting vertebra on an antero-posterior radiogram of the spine.

    Measured: 12 months follow-up

Secondary outcomes (8)
  1. Cobb angle measurement

    Cobb's angle represents the gold standard for measuring the extent of the scoliotic curve; it is identified as the angle between the two lines passing through the upper limiting vertebra and the lower limiting vertebra on an antero-posterior radiogram of the spine.

    Measured: baseline (post-surgery), 2 months, 6 months, 24 months and 60 months follow-up

  2. NRS (Numeric Rating Scale)

    NRS is a quantitative one-dimensional numerical scale, used to measure pain intensity, involves the practitioner asking the patient to select the number that best describes the intensity of his or her pain, from 0 to 10, at that specific time.

    Measured: baseline, 2 months, 6 months, 12 months, 24 months and 60 months follow-up

  3. SRS-22 (Scoliosis Research Society-22)

    SRS-22 is a questionnaire that is the most common measure for assessing quality of life in patients with spinal deformities. assesses five domains:

    1. function
    2. pain
    3. mental health
    4. self-image
    5. satisfaction/ dissatisfaction Each domain contains five questions, except for the last one, which has two questions.

    The score for each question ranges from 1 to 5. The sum of the first four domains forms an initial partial score, which can be up to 100. The total score is given by adding the last item as well, for a maximum score of 110. The purpose of the SRS-22 is to provide an assessment of pathology and patient perception regarding both the consequences of treatment choices and the effectiveness of treatment.

    Measured: baseline, 2 months, 6 months, 12 months, 24 months and 60 months follow-up

  4. Oswestry Disability Index (ODI)

    The ODI index is a valuable tool for assessing patient satisfaction in view of the patient's current clinical picture. It consists of ten sections investigating the influence of spinal pathology on different aspects of daily life: (pain intensity; personal hygiene; lifting weights; walking; sitting; standing; sleeping; sexual life; social life; traveling).

    Each section contains within it 6 possible answers with scores ranging from 0 to 5 where 0 corresponds to no difficulty or pain while 5 inability to perform the activity or disabling pain

    Measured: baseline, 2 months, 6 months, 12 months, 24 months and 60 months follow-up

  5. Final treatment opinion

    The patient should indicate satisfaction and relative degree with treatment. All patients will be able to indicate their health condition by choosing from this answers; "Full recovery", "much better", "somewhat better", "no change", "a little worse", "much worse".

    Measured: 2 months, 6 months, 12 months, 24 months and 60 months follow-up

  6. Screw malposition rate

    Screw malposition rate will be evaluated by a CT scan and the Brantigan score will be applied to document screw fusion.

    Measured: 6 months

  7. Incidence of mechanical complications

    Rod Fracture, screw loosening or junctional kyphosis will be evaluated with radiographs

    Measured: 2 months, 6 months, 12 months, 24 months and 60 months of follow-up

  8. Intraoperative and immediate postoperative outcomes

    Differences in terms of operative time, blood loss, length of stay, time to verticalization, drug use

    Measured: through study completion, up to 5 years

Timeline

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

  1. First posted16 May 2023
  2. Study start15 Jul 2023
  3. Primary completionJun 2027 (estimated)
  4. Study completionJun 2032 (estimated)

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
This is a randomized trial with 1:1 allocation.
Masking
None (open label)
Enrolment
126 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05860673
Sponsor's protocol ID
MISpro
Status last verified
Jun 2025
First submitted
8 May 2023
Last updated
4 Jun 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Shakil H, Iqbal ZA, Al-Ghadir AH. Scoliosis: review of types of curves, etiological theories and conservative treatment. J Back Musculoskelet Rehabil. 2014;27(2):111-5. doi: 10.3233/BMR-130438.

    PubMed 24284269
  • Sarwahi V, Horn JJ, Kulkarni PM, Wollowick AL, Lo Y, Gambassi M, Amaral TD. Minimally Invasive Surgery in Patients With Adolescent Idiopathic Scoliosis: Is it Better than the Standard Approach? A 2-Year Follow-up Study. Clin Spine Surg. 2016 Oct;29(8):331-40. doi: 10.1097/BSD.0000000000000106.

    PubMed 24852384
  • Sarwahi V, Galina JM, Hasan S, Atlas A, Ansorge A, De Bodman C, Lo Y, Amaral TD, Dayer R. Minimally Invasive Versus Standard Surgery in Idiopathic Scoliosis Patients: A Comparative Study. Spine (Phila Pa 1976). 2021 Oct 1;46(19):1326-1335. doi: 10.1097/BRS.0000000000004011.

    PubMed 34517401
  • Alhammoud A, Alborno Y, Baco AM, Othman YA, Ogura Y, Steinhaus M, Sheha ED, Qureshi SA. Minimally Invasive Scoliosis Surgery Is a Feasible Option for Management of Idiopathic Scoliosis and Has Equivalent Outcomes to Open Surgery: A Meta-Analysis. Global Spine J. 2022 Apr;12(3):483-492. doi: 10.1177/2192568220988267. Epub 2021 Feb 9.

    PubMed 33557618
  • Neradi D, Kumar V, Kumar S, Sodavarapu P, Goni V, Dhatt SS. Minimally Invasive Surgery versus Open Surgery for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis. Asian Spine J. 2022 Apr;16(2):279-289. doi: 10.31616/asj.2020.0605. Epub 2021 May 11.

    PubMed 33966365
  • Si G, Li T, Wang Y, Liu X, Li C, Yu M. Minimally invasive surgery versus standard posterior approach for Lenke Type 1-4 adolescent idiopathic scoliosis: a multicenter, retrospective study. Eur Spine J. 2021 Mar;30(3):706-713. doi: 10.1007/s00586-020-06546-w. Epub 2020 Jul 27.

    PubMed 32720126
  • Maccaferri B, Filardo G, Cini C, Gasbarrini A, Vommaro F. Adolescent idiopathic scoliosis: a prospective randomised trial protocol comparing clinical and radiological outcomes in minimally invasive surgery versus standard posterior spinal fusion in a single-centre, the Rizzoli Orthopaedic Institute, Bologna, Italy. BMJ Open. 2024 Jul 16;14(7):e075802. doi: 10.1136/bmjopen-2023-075802.

    PubMed 39013643

Questions about this trial

What is this clinical trial studying?

A study testing mini invasive scoliosis surgery and posterior spinal fusion technique in people with Adolescent Idiopathic Scoliosis, run by Istituto Ortopedico Rizzoli at 1 site in Italy.

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 5 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 4 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Alessandro Gasbarrini, MD (6366528 ext. 051, alessandro.gasbarrini@ior.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cobb angle measurement (time frame: 12 months follow-up). 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 NCT05860673, which also lists 7 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 4 Jun 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in