N/A
N=345
Safety and Efficacy Study Comparing ProDisc-C to ACDF Surgery to Treat SCDD
Symptomatic Cervical Disc Disease
Bottom Line
View on ClinicalTrials.gov: NCT00291018 ↗Enrolled (actual)
345
Serious AEs
45.2%
Results posted
Mar 2017
Primary outcome: Primary: Overall Success — 62.8; 53.2; 62.7 % of Subjects
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Total Disc Replacement (Device); ACDF (Device)
- Age
- Adult · 18+ yrs
- Sex
- All
- Sponsor
- Synthes USA HQ, Inc.
- Primary completion
- Mar 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Success |
62.8; 53.2; 62.7 | — |
| SECONDARY Neurologic Success |
87.0; 89.1; 93.5 | — |
| SECONDARY NDI |
84.6; 84.4; 81.7; 9.0; 9.4; 9.7 | — |
| SECONDARY SF-36 Physical Composite Score (PCS) |
78.2; 74.2; 68.9; 7.7; 16.1; 11.1 | — |
| SECONDARY SF-36 Mental Composite Score (MCS) |
52.6; 50.0; 54.4; 19.2; 22.6; 21.1 | — |
| SECONDARY VAS Satisfaction |
86.16; 82.09; 86.51 | — |
| SECONDARY VAS Neck Pain Intensity |
76.9; 72.6; 78.5; 10.3; 14.5; 17.2 | — |
| SECONDARY VAS Neck Pain Frequency |
78.2; 74.2; 73.1; 10.3; 11.3; 12.9 | — |
| SECONDARY VAS Arm Pain Intensity |
66.7; 74.2; 68.8; 16.7; 9.7; 15.1 | — |
| SECONDARY VAS Arm Pain Frequency |
61.5; 75.4; 66.7; 21.8; 8.2; 15.1 | — |
| SECONDARY Surgery Again |
92.3; 81.3; 91.3; 6.4; 14.1; 7.6 | — |
Summary
The objective of this clinical investigation is to compare the safety and effectiveness of ProDisc-C to anterior cervical discectomy and fusion (ACDF) surgery in the treatment of symptomatic cervical disc disease (SCDD).
Eligibility Criteria
Inclusion Criteria
- Symptomatic cervical disc disease (SCDD) in one vertebral level between C3-C7 defined as: Neck or arm (radicular) pain; and/or a functional/neurological deficit with at least one of the following conditions confirmed by imaging (CT, MRI or X-rays): Herniated nucleus pulposus; Spondylosis (defined by the presence of osteophytes); and/or Loss of disc height.
- Age between 18 and 60 years.
- Unresponsive to non-operative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root/spinal cord compression in the face of conservative treatment.
- NDI score greater than or equal to 15/50 (30%).
- Psychosocially, mentally and physically able to fully comply with the protocol including adhering to follow-up schedule and requirements and filling out forms.
- Signed informed consent.
Exclusion Criteria
- More than one vertebral level requiring treatment.
- Marked cervical instability on resting lateral or flexion/extension radiographs: translation greater than 3mm and/or greater than 11 degrees of rotational difference to that of either adjacent level.
- Has a fused level adjacent to the level to be treated.
- Radiographic confirmation of severe facet joint disease or degeneration.
- Known allergy to cobalt, chromium, molybdenum, titanium or polyethylene.
- Clinically comprised vertebral bodies at the affected level(s) due to current or past trauma, e.g. by the radiographic appearance of fracture callus, malunion or nonunion.
- Prior surgery at the level to be treated.
- Severe spondylosis at the level to be treated as characterized by any of the following: Bridging osteophytes; A loss of disc height greater than 50%; or Absence of motion (<2°).
- Neck or arm pain of unknown etiology.
- Osteoporosis: A screening questionnaire for osteoporosis, SCORE (Simple Calculated Osteoporosis Risk Estimation), will be used to screen patients who require a DEXA (dual energy x-ray absoptiometry) bone mineral density measurement. If DEXA is required, exclusion will be defined as a DEXA bone density measured T score less than or equal to -2.5 (the World Health Organization definition of osteoporosis).
- Paget's disease, osteomalacia or any other metabolic bone disease (excluding osteoporosis which is addressed above).
- Severe diabetes mellitus requiring daily insulin management.
- Pregnant or interested in becoming pregnant in the next three years.
- Active infection - systemic or local.
- Taking medications or any drug known to potentially interfere with bone/soft tissue healing (e.g., steroids).
- Rheumatoid arthritis or other autoimmune disease.
- Systemic disease including AIDS, HIV, hepatitis.
- Active malignancy: A patient with a history of any invasive malignancy (except non-melanoma skin cancer), unless he/she has been treated with curative intent and there have been no clinical signs or symptoms of the malignancy for at least 5 years.
Data sourced from ClinicalTrials.gov (NCT00291018). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.