Spine Fusion Clinical Trial
Official title:
Prospective Study on Clinical and Radiological Results With Ennovate® Pedicle Screw Fixation in Isthmic Spondylolisthesis Patients
The present study is planned to demonstrate the efficacy and safety of a new pedicle screw system for the specific indication of isthmic spondylolisthesis, as this condition concerns relatively young patients requiring good fixation of the performed reposition to come to satisfactory clinical results.
Adult Isthmic spondylolisthesis, which is associated with "spondylolysis," is defined as an
osseous discontinuity of the vertebral arch at the isthmus (the pars interarticularis), which
usually occurs in the fifth lumbar vertebra. The prevalence of isthmic spondylosis is
proposed to be about 6% to 26% in different studies. The European Spine Tango registry found
15%. It is proposed to affect more men than women. Conservative treatments including braces,
physical therapy, and medication are shown to be effective for some patients; however,
surgical treatments are mainly the final effective treatment. There are several different
options for surgery among which posterolateral fusion (PLF) is considered as the method of
choice. It is shown that PLF is more effective than conservative treatments such as exercise.
The fusion helps to fix the motion of the affected segment and therefore, might lead to pain
reduction. Decompression, supplemental instrumentation, and supplemental anterior column
support are also considered for treatment. These treatment strategies can be used separately
or in any combination; however, studies trying to compare separate treatments with a
combination of them have led to inconsistent results.
Supplementary pedicle screws might be added to fusion methods for fixation and it is proposed
that they have the ability to correct the deformity, reduce the listhesis, and increase the
fusion rates, although a majority of the studies comparing instrumented PLF and
noninstrumented PLF could not show the superiority of instrumented approaches. The literature
has been reviewed in 2000 already, and the method has already been proved to be "practical,
safe, and effective" for various spinal indications. Other authors found a better result for
isthmic spondylolisthesis patients with posterior lumbar interbody Fusion (PLIF), vs. PLF,
especially for high grade isthmic spondylolisthesis.
The present study is planned to demonstrate the efficacy and safety of a new pedicle screw
system for the specific indication of isthmic spondylolisthesis, as this condition concerns
relatively young patients requiring good fixation also in the long-term.
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