Lumbar Fusion With 3D-Printed Porous Titanium Interbody Cages - A Single-Blinded Randomized Controlled Trial Evaluating Nexxt Matrixx(TM) Versus PEEK Cages
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Lumbar Degenerative Disc Disease
- Sponsor
- Ohio State University
- Enrollment
- 53
- Locations
- 1
- Primary Endpoint
- Interbody Radiographic Fusion Rate
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this randomized controlled trial is to assess and compare radiographic and clinical outcomes in patients who are to undergo combined interbody/posterolateral lumbar fusion procedures, supplemented with pedicle screw instrumentation, using one of the following interbody cages; the Nexxt Spine Nexxt MatrixxTM 3D-printed titanium cage or the HonourTM poly-ether-ether-ketone cage.
Detailed Description
This randomized controlled trial will prospectively evaluate the safety and efficacy of the Nexxt MatrixxTM System titanium implant supplemented with a pedicle screw system as compared to a representative PEEK cage currently used in routine fashion for lumbar interbody fusion procedures. This study will capture clinical and radiographic outcomes on patients up to 2 years post operatively. Both cages will be used in conjunction with milled local autograft bone generated as part of the spinal fusion procedure (no iliac crest autograft will be utilized). This single centered study will enroll up to 70 subjects (n = 35 per group), with subjects followed for 24 months post-surgery. All subjects enrolled in the study will be recruited from a pool of subjects eligible for combined interbody/posterolateral lumbar fusion surgery. Subjects will be randomized in the trial to receive either the Nexxt Spine Nexxt MatrixxTM 3D-printed titanium cage or the HonourTM PEEK cage supplemented with a pedicle screw system and milled local autograft bone. Subject randomization will be stratified according to smoking status. Subjects will be blinded to their group status for the duration of the study assessments and procedures (24 months post-operatively). Subject study data will be collected preoperatively, intra-operatively and postoperatively at 3, 6, 12, and 24 months.
Investigators
Andrew Grossbach
Assistant Professor, Department of Neurological Surgery
Ohio State University
Eligibility Criteria
Inclusion Criteria
- •Subject is scheduled to undergo combined interbody and posterolateral spinal fusion surgery using either the Nexxt MatrixxTM 3D-printed titanium cage or HonourTM PEEK cage in conjunction with local autograft bone, and supplementation with a pedicle screw system.
- •Subject must be over the age of 18 years old.
- •Subject has been unresponsive to conservative care for a minimum of 6 months.
- •The subject must in the investigator's opinion, be psychosocially, mentally, and physically able to fully comply with this protocol including the required follow-up visits, the filling out of required forms, and have the ability to understand and give written informed consent.
Exclusion Criteria
- •Subjects with previous lumbar arthrodesis surgery.
- •Subjects requiring additional bone grafting materials other than local autograft bone.
- •Subject has inadequate tissue coverage over the operative site.
- •Subject has an open wound local to the operative area, or rapid joint disease, bone absorption, or osteoporosis.
- •Subject has a condition requiring medications that may interfere with bone or soft tissue healing (i.e., oral or parenteral glucocorticoids, immunosuppressives, methotrexate, etc.).
- •Subject has an active local or systemic infection.
- •Subject has a metal sensitivity/foreign body sensitivity.
- •Subject is morbidly obese, defined as a body mass index (BMI) greater than
- •Subject has any medical condition or extenuating circumstance that, in the opinion of the investigator, would preclude participation in the study.
- •Subject is currently involved in another investigational drug or device study that could confound study data.
Outcomes
Primary Outcomes
Interbody Radiographic Fusion Rate
Time Frame: 6 months post-operatively
Interbody fusion will be graded using the Brantigan, Steffee, Fraser (BSF) Scale which classifies fusion between the interbody cage and adjacent bone on a scale of 1-3 where a higher score indicates a better outcome. The grades are defined as follows: Brantigan, Steffee, Fraser-Grade 1 (BSF-1) indicates radiographical pseudarthrosis, Brantigan, Steffee, Fraser-Grade 2 (BSF-2) is defined by radiographical locked pseudarthrosis, and Brantigan, Steffee, Fraser-Grade 3 (BSF-3) is radiographical fusion, indicating the best outcome. The subject will be considered a success if fusion is a Grade BSF-3 at 6 months.
Secondary Outcomes
- Post-operative Timing of Fusion(12 months post-operatively)