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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04639297
Other study ID # 19121607
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date September 28, 2020
Est. completion date June 20, 2026

Study information

Verified date March 2024
Source Rush University Medical Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to perform a prospective, randomized, controlled clinical trial to assess the utility of IONM in patients undergoing primary, single or multilevel lateral spinal procedures. Subjects will be randomized to undergo a lateral spine surgery with the use of NeuroVision® IONM or conventional hospital based IONM to assess incidence of new-onset neurological injury.


Description:

Elective spinal surgery for the correction of degenerative spinal pathology may involve significant intraoperative risks that can influence postoperative neurologic outcomes. Spinal cord monitoring had made it possible to track the spine and nerve root sensory and motor tracts. This has improved the ability to conduct minimally invasive surgery by allowing surgeons to operate without direct visualization of the neurologic elements. Intraoperative neuromonitoring (IONM) of the spinal cord is primarily accomplished by both somatosensory evoked potentials (SSEP) and transcranial motor evoked potentials (tcMEPs). Due to a shortage in personnel trained to evaluate neuro-monitoring results, surgeon-driven systems have been established. An example of a surgeon driven monitoring system is NeuroVision®, which interacts with the surgeon during the operation by providing real-time visible and auditory tcMEP and compound muscle action potential (CMAP) waveforms. This stands in comparison to hospital based methods of IONM.


Recruitment information / eligibility

Status Recruiting
Enrollment 148
Est. completion date June 20, 2026
Est. primary completion date December 20, 2025
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group N/A and older
Eligibility Inclusion Criteria: - Patients undergoing a primary single or multilevel lateral spinal surgery procedures for degenerative pathology Diagnosis: myelopathy, radiculopathy, myeloradiculopathy, central stenosis, foraminal stenosis herniated nucleus pulposus, degenerative disc disease, spondylosis, and osteophytic complexes - Patients able to provide informed consent Exclusion Criteria: - Active infection - Active or history of malignancy - Spinal traumatic injury within the past 2 years

Study Design


Related Conditions & MeSH terms


Intervention

Device:
NeuroVision® IONM
Using NeuroVision® prior to surgery SSEP and tcMEP and values are recorded. A deficit of SSEP tracking is defined as an amplitude reduction of more than 10% or a latency increase more than 50%. Similarly, a CMAP amplitude reduction demonstrates problematic tcMEP monitoring.
Hospital Based IONM
Using hospital based IONM prior to surgery SSEP and tcMEP and values are recorded. A deficit of SSEP tracking is defined as an amplitude reduction of more than 10% or a latency increase more than 50%. Similarly, a CMAP amplitude reduction demonstrates problematic tcMEP monitoring.

Locations

Country Name City State
United States Rush University Medical Center Chicago Illinois

Sponsors (1)

Lead Sponsor Collaborator
Rush University Medical Center

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Incidence of new-onset neurological injury Decreased somatosensory evoked potentials (SSEP) and transcranial MEPs (tcMEPs) Enrollment up to 2 years postoperatively
Secondary Cost analysis of IONM use Difference in costs of hospital IONM and Neurovision Enrollment up to 1 month post-operative
Secondary False positive and false negative events in each modality Incorrect labeling of SSEP, tcMEP, and surface electromyography (sEMG) signals Intraoperatively up to 1 day post-operative
Secondary Adverse Events Post-operative nausea and vomiting, Gastro-esophageal reflux, ileus, urinary tract infection, venous thromboembolic events, Respiratory depression/airway compromise,m renal insufficiency, wound complications Postoperative to documented progress assessed up to 2 months
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