A Pivotal Study of rhBMP-2/ACS/LT-CAGE® Device for Anterior Lumbar Interbody Fusion in Patients With Degenerative Disc Disease

Degenerative Disc Disease Clinical Trial

Official title:

A Clinical Investigation of Recombinant Human Bone Morphogenetic Protein-2 and Absorbable Collagen Sponge With the LT-CAGE® Device for Anterior Lumbar Interbody Fusion in Patients With Symptomatic Degenerative Disc Disease

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01491425
• Other study ID #: C-9803
• Status: Completed
• Phase: N/A
• Start date: November 1998
• Est. completion date: October 2002

Study information

• Verified date: May 2023
• Source: Medtronic Spinal and Biologics
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is designed to assess the safety and effectiveness of the rhBMP-2/ACS/LT-CAGE® Device using laparoscopic surgical technique as compared to an historical control group treated with Autogenous Bone/LT-CAGE® Device using an open surgical technique in patients with symptomatic degenerative disc disease.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 134
• Est. completion date: October 2002
• Est. primary completion date: October 2002
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Has degenerative disc disease as noted by back pain of discogenic origin, with or without leg pain, with degeneration of the disc confirmed by patient history ( e.g.,pain [leg, back, or symptoms in the sciatic nerve distribution], function deficit and/or neurological deficit)and radiographic studies ( e.g., CT, MRl, X-Ray, etc.) to include one or more of the following:

• instability( defined as angular motion > 5° and/or translation >= 2-4mm, based on Flex/Ext radiographs);

• osteophyte formation;

• decreased disc height;

• thickening of ligamentous tissue;

• disc degeneration or herniation; and/or

• facet joint degeneration.

2. Has preoperative Oswestry score > 35.

3. Has no greater than Grade 1 spondylolisthesis utilizing Meyerding's Classification (Meyerding HW, 1932.).

4. Has single-level symptomatic degenerative involvement from L4 to S1.

5. Is at least 18 years of age, inclusive, at the time of surgery.

6. Has not responded to non-operative treatment (e.g., bed rest, physical therapy, medications, spinal injections, manipulation, and/or TENS) for a period of at least 6 months.

7. If female of child-bearing potential, who is not pregnant or nursing, and who agrees to use adequate contraception for 16 weeks following surgery.

8. Is willing and able to comply with the study plan and sign the Patient Informed Consent Form.

Exclusion Criteria:

1. Had previous anterior spinal fusion surgical procedure at the involved level.

2. Has posterior spinal instrumentation (which will not be removed) stabilizing the involved level or has had a previous posterior lumbar interbody fusion procedure at the involved level.

3. Has a condition which requires postoperative medications that interfere with fusion, such as steroids.

4. Has been previously diagnosed with osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated.

5. Has presence of active malignancy.

6. Has overt or active bacterial infection, either local or systemic.

7. Is grossly obese, i.e., weight > 40% over ideal for their age and height.

8. Has fever ( temperature > 101° F oral) at the time of surgery.

9. Has a documented titanium alloy allergy or intolerance.

10. Is mentally incompetent. if questionable, obtain psychiatric consult.

11. Has a Waddell Signs of Inorganic Behavior score of 3 or greater.

12. Is a prisoner.

13. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug usage.

14. Is a tobacco user at the time of surgery.

15. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal fusion surgery (e.g., steroids or methotrexate).

16. Has a history of autoimmune disease (Systemic Lupus Erythematosus or Dermatomyositis).

17. Has a history of exposure to injectable collagen implants.

18. Has a history of hypersensitivity to protein pharmaceuticals (monoclonal antibodies or gamma globulins) or collagen.

19. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following rhBMP-2/ACS implantation.

20. Has received any previous exposure to any/all BMP's of either human or animal extraction.

21. Has a history of allergy to bovine products or a history of anaphylaxis.

22. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers- Danlos syndrome, or osteogenesis imperfecta).

Related Conditions & MeSH terms

• Degenerative Disc Disease
• Intervertebral Disc Degeneration
• Spinal Diseases

Intervention

Device:
• rhBMP-2/ACS//LT-CAGE® Device
LT-CAGE® device with recombinant human bone morphogenetic protein-2 ( rhBMP-2) and the absorbable collagen sponge (ACS).
• Autogenous Bone//LT-CAGE® Device
LT-CAGE® device with autogenous bone taken from the iliac crest.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Medtronic Spinal and Biologics

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Success	A patient will be considered an overall success if all of the following conditions are met: fusion; pain/disability (Oswestry) improvement; maintenance or improvement in neurological status; no serious adverse event classified as implant associated or implant/surgical procedure associated; no additional surgical procedure classified as a "failure."	24 month
Secondary	Disc Height Measurement		24 month
Secondary	General Health Status (SF-36)		24 month
Secondary	Pain Status (Numerical Rating Scale)		24 month
Secondary	Patient Satisfaction		24 month
Secondary	Patient Global Perceived Effect		24 month