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Mid- or High-flex Rods Versus Low-flex Rods of SpineShape System IV for Treatment of Degenerative Lumbar Spine Diseases

Not Applicable
Recruiting
Conditions
Degenerative Spondylolisthesis
Facet Joint Arthrosis
Spondylarthritis
Discopathy
Instability Lumbar Spine
Degenerative Lumbar Spinal Stenosis
Interventions
Device: SpineShape System IV straight rod stiff
Device: SpineShape System IV straight rod elastic
Device: SpineShape System IV straight rod medium
Registration Number
NCT06320899
Lead Sponsor
SpineSave AG
Brief Summary

The purpose of this multi-center, randomized, clinical study is to show that the treatment of degenerative lumbar spine with high- or mid-flex rods is not inferior to the treatment with low-flex rods in terms of clinical and safety-related results.

The primary aim is to compare the reduction in back pain after the treatment with high- or mid-flex rods with that after treatment with low-flex rods. Secondary, the functionality after treatment with high- or mid-flex rods will be compared to that after treatment with low-flex rods.

Detailed Description

Dynamic stabilization systems for the lumbar spine are no novelty. The SpineShape System IV builds on the experience of previous systems and attempts to provide additional benefits primarily through three different and relatively elastic rod stiffnesses. 126 subjects with degenerative symptoms in 1 to 2 segments of the lumbar spine L1 to S1 will be recruited. The participants will be randomized in a 1:1:1 ratio to undergo implantation of either the elastic (experimental product group 1), medium (experimental product group 2) or stiff rod (comparison product group).

The aim of the study is to show that the treatment of degenerative lumbar spine with elastic or medium rod variants is not inferior to treatment with hard rods in terms of clinical and safety-related results. This is checked by completing a questionnaire before the surgical procedure and 3 months, 12 months, 24 months and 60 months after the surgical procedure.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
126
Inclusion Criteria
  • degenerative symptoms in 1 to 2 segments in the lumbar spine L1-S1

  • signed informed consent of participant

  • confirmation of the participant that the attendance of follow-up visits are intended

  • Body-Mass-Index < 32

  • Pedicle screw axis distance < 30mm

  • one or more of the following indications:

    • (dynamic) stenosis in the spinal canal
    • neuroforaminal stenosis
    • facet joint syndrome / spondylarthrosis
    • discopathy (recurrent disc hernia)
    • degenerative spondylolisthesis (Meyerding <1)
    • instability (hypermobility with antelishtesis, hypomobility with retrolisthesis if decompressed)
Exclusion Criteria
  • missing bone structure, e.g. due to congenital anomalies or sever anatomical deformities that make anchoring of the implant impossible
  • damaged structural tissue, e.g. due to a bone fracture
  • application to the thoracic or cervical spine
  • pronounced idiopathic scoliosis
  • spondylolisthesis > Meyerding grad 1
  • isthmic spondolylysis
  • bone tumor
  • osteochondrosis modic type I, II or III
  • osteoporosis, which could impair screw anchoring
  • history with third party implants
  • patients with an active local or systemic infection
  • known allergy to titatnium alloys
  • skeleton in growth (epiphyseal joints not closed)
  • severe muscular neuronal or vascular disease
  • immunosuppresive therapy
  • long-term therapy with cortisone
  • heavy smokers (regular consumption of more than six cigarettes per day), drug addicts and alcoholics
  • chronic pain patients
  • incapable of judgment or emergency situation
  • implantation during pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SpineShape System IV straight rod stiffSpineShape System IV straight rod stiffDynamic stabilization of lumbar segments using SpineShape System IV straight rod stiff (low-flex)
SpineShape System IV straight rod elasticSpineShape System IV straight rod elasticDynamic stabilization of lumbar segments using SpineShape System IV straight rod elastic (high-flex)
SpineShape System IV straight rod mediumSpineShape System IV straight rod mediumDynamic stabilization of lumbar segments using SpineShape System IV straight rod medium (mid-flex)
Primary Outcome Measures
NameTimeMethod
Visual Analogue Scale (VAS) lower back pain24 months post-implantation

self reported back pain intensity using Visual Analogue Scale system. 0 "no pain" to 10 "worst possible pain"

Secondary Outcome Measures
NameTimeMethod
segmental mobility index level3, 12, 24, 60 months post-implantation

measuring the segmental mobility at index level to verify the preservation of the mobility. an average mobility per segment of \>1° is considered a success

medication consumption3, 12, 24, 60 months post-implantation

use of none, mild pain medication, non-steroidal anti-inflammatory drugs, opioids, and/or antidepressiva documented in patient's health records

Visual Analogue Scale (VAS) leg pain3, 12, 24, 60 months post-implantation

self reported leg pain intensity using Visual Analogue Scale system. 0 "no pain" to 10 "worst possible pain"

walking duration3, 12, 24, 60 months post-implantation

self reported walking duration in 5 categories (0-5 min, 6-15 min, 16-30 min, 31-60 min and \>60min)

adverse eventsafter 3, 12, 24, 60 months post-implantation

adverse events related to the device (e.g. screw loosening, screw breakage, torn rod, slipped rod or too short rod)

ability to work/ activity (for retirees)3, 12, 24, 60 months post-implantation

self reported ability to work or activity (for retirees) in 5 categories (0%, 25%, 50%, 75%, 100%)

Trial Locations

Locations (2)

Spital Aarberg

🇨🇭

Aarberg, Switzerland

Hirslanden Klinik Linde

🇨🇭

Biel, Switzerland

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