Osteoporosis Clinical Trial
— 3DCOPOfficial title:
3D-printed Porous Titanium Alloy Cages Versus PEEK Cages: Pedicle Screw Loosening Rate and Fusion Rate in Patients With Osteoporosis
Verified date | September 2021 |
Source | Peking University Third Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
This is a prospective,observational single-center study. The osteoporotic patients requiring posterior lumbar interbody fusion(PLIF) with cages at the lowest fusion segment are prospectively enrolled and followed up. The patients undergoing PLIF with the 3D-printed porous titanium alloy cages are compared with those using PEEK cages. The hypothesis is that the use of 3D-printed porous titanium alloy cages can reduce the rate of pedicle screw loosening and increase the rate of lumbar fusion in osteoporotic patients.
Status | Enrolling by invitation |
Enrollment | 90 |
Est. completion date | December 31, 2022 |
Est. primary completion date | December 31, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 50 Years and older |
Eligibility | Inclusion Criteria: - aged= 50 years old - lumbar degenerative diseases requiring lumbar fusion with pedicle screw fixation, such as degenerative lumbar spinal stenosis, degenerative lumbar spondylolisthesis. - no response to nonoperative treatment of at least 3 months - osteoporosis diagnosed by any method for bone mineral density evaluation, such as DXA, QCT,or vertebral Hounsfield units - the lowest instrumented vertebrae were at L5 or S1 - the surgical plan includes lumbar interbody fusion with cages at the lowest fusion level - informed consent Exclusion Criteria: - the surgical plan includes any techniques used to strengthen the fixation,such as augmentation of the pedicle screw with bone cement - no lumbar CT scans within 3 months before the surgery - no dual energy x-ray absorptiometry within 6 months before the surgery - spondylolysis - allergic to metal - history of lumbar fusion surgery - cervical myelopathy,thoracic spinal stenosis, motor neuron disease,tuberculosis of spine,spinal tumor |
Country | Name | City | State |
---|---|---|---|
China | Peking University Third Hospital | Beijing | Beijing |
Lead Sponsor | Collaborator |
---|---|
Peking University Third Hospital |
China,
Amirouche F, Solitro GF, Magnan BP. Stability and Spine Pedicle Screws Fixation Strength-A Comparative Study of Bone Density and Insertion Angle. Spine Deform. 2016 Jul;4(4):261-267. doi: 10.1016/j.jspd.2015.12.008. Epub 2016 Jun 16. — View Citation
Bokov A, Bulkin A, Aleynik A, Kutlaeva M, Mlyavykh S. Pedicle Screws Loosening in Patients With Degenerative Diseases of the Lumbar Spine: Potential Risk Factors and Relative Contribution. Global Spine J. 2019 Feb;9(1):55-61. doi: 10.1177/2192568218772302. Epub 2018 May 24. — View Citation
Bredow J, Boese CK, Werner CM, Siewe J, Löhrer L, Zarghooni K, Eysel P, Scheyerer MJ. Predictive validity of preoperative CT scans and the risk of pedicle screw loosening in spinal surgery. Arch Orthop Trauma Surg. 2016 Aug;136(8):1063-7. doi: 10.1007/s00402-016-2487-8. Epub 2016 Jun 16. — View Citation
Chen P, Li Z, Hu Y. Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health. 2016 Oct 3;16(1):1039. Review. — View Citation
Galbusera F, Volkheimer D, Reitmaier S, Berger-Roscher N, Kienle A, Wilke HJ. Pedicle screw loosening: a clinically relevant complication? Eur Spine J. 2015 May;24(5):1005-16. doi: 10.1007/s00586-015-3768-6. Epub 2015 Jan 24. Review. — View Citation
Goldstein CL, Brodke DS, Choma TJ. Surgical Management of Spinal Conditions in the Elderly Osteoporotic Spine. Neurosurgery. 2015 Oct;77 Suppl 4:S98-107. doi: 10.1227/NEU.0000000000000948. Review. — View Citation
Janssen I, Ryang YM, Gempt J, Bette S, Gerhardt J, Kirschke JS, Meyer B. Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine. Spine J. 2017 Jun;17(6):837-844. doi: 10.1016/j.spinee.2017.01.009. Epub 2017 Jan 17. — View Citation
Li P, Jiang W, Yan J, Hu K, Han Z, Wang B, Zhao Y, Cui G, Wang Z, Mao K, Wang Y, Cui F. A novel 3D printed cage with microporous structure and in vivo fusion function. J Biomed Mater Res A. 2019 Jul;107(7):1386-1392. doi: 10.1002/jbm.a.36652. Epub 2019 Mar 18. — View Citation
McGilvray KC, Easley J, Seim HB, Regan D, Berven SH, Hsu WK, Mroz TE, Puttlitz CM. Bony ingrowth potential of 3D-printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model. Spine J. 2018 Jul;18(7):1250-1260. doi: 10.1016/j.spinee.2018.02.018. Epub 2018 Feb 26. — View Citation
Okuyama K, Abe E, Suzuki T, Tamura Y, Chiba M, Sato K. Influence of bone mineral density on pedicle screw fixation: a study of pedicle screw fixation augmenting posterior lumbar interbody fusion in elderly patients. Spine J. 2001 Nov-Dec;1(6):402-7. — View Citation
Pannell WC, Savin DD, Scott TP, Wang JC, Daubs MD. Trends in the surgical treatment of lumbar spine disease in the United States. Spine J. 2015 Aug 1;15(8):1719-27. doi: 10.1016/j.spinee.2013.10.014. Epub 2013 Oct 31. — View Citation
Tokuhashi Y, Matsuzaki H, Oda H, Uei H. Clinical course and significance of the clear zone around the pedicle screws in the lumbar degenerative disease. Spine (Phila Pa 1976). 2008 Apr 15;33(8):903-8. doi: 10.1097/BRS.0b013e31816b1eff. — View Citation
* Note: There are 12 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Pedicle screw loosening rate at the lowest instrumented vertebrae | The presence of radiolucent zones of = 1mm thick around the pedicle screws, broken screws, or obvious screw back-out and cut-out on x-ray images. | 6 months | |
Primary | Fusion rate at the lowest fusion level | The presence of continuous fusion mass at bone graft site in CT scans and less than 3 degree of intervertebral mobility on lateral flextion-extension x-ray images. | 6 months | |
Secondary | Pedicle screw loosening rate at the lowest instrumented vertebrae | The presence of radiolucent zones of = 1mm thick around the pedicle screws, broken screws, or obvious screw back-out and cut-out on x-ray images. | 3 months;12 months; 24 months | |
Secondary | Fusion rate at the lowest fusion level | The presence of continuous fusion mass at bone graft site in CT scans and less than 3 degree of intervertebral mobility on lateral flextion-extension x-ray images. | 3 months;12 months; 24 months | |
Secondary | Disability | The Oswestry Disability Index (ODI) (0-100) is used to assess disability. | 3 months; 6 months;12 months; 24 months | |
Secondary | Back pain | The Visual Analog Scale (VAS 0-10) is used the evaluate back pain. | 3 months; 6 months;12 months; 24 months | |
Secondary | Leg pain | The Visual Analog Scale (VAS 0-10) is used the evaluate leg pain. | 3 months; 6 months;12 months; 24 months |
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