Pivotal Study of rhBMP-2/ACS/Allograft Bone Dowel for Anterior Lumbar Interbody Fusion in Patients With Symptomatic Degenerative Disc Disease

Not Applicable

Terminated

• Conditions: Degenerative Disc Disease
• Interventions: Device: rhBMP-2/ACS/allograft bone dowel; Procedure: Autogenous bone/allograft bone dowel

• Registration Number: NCT01494493
• Lead Sponsor: Medtronic Spinal and Biologics

Brief Summary

The purpose of this clinical trial is to evaluate the implant (rhBMP-2/ACS/allograft bone dowel) as a method of facilitating spinal fusion in patients with degenerative disc disease.

Detailed Description

Not available

Study Timeline

• Study Start: 2000-09
• Primary Completion: 2004-02
• Study Completion: 2004-02
• Study First Submitted: 2011-12-12
• Study First Submitted QC: 2011-12-15
• Study First Posted: 2011-12-19
• Status Verified: 2023-05
• Last Update Submitted: 2023-05-16
• Last Update Posted: 2023-05-17

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 85

Inclusion Criteria

1. Has degenerative disc disease as noted by back pain of discogenic origin, with or without leg pain, with degeneration of the disc confirmed by patient history ( e.g.,pain [leg, back, or symptoms in the sciatic nerve distribution], function deficit and/or neurological deficit)and radiographic studies ( e.g., CT, MRl, X-Ray, etc.) to include one or more of the following:

   • instability( defined as angular motion > 5° and/or translation >= 2-4mm, based on Flex/Ext radiographs);
   • osteophyte formation;
   • decreased disc height;
   • thickening of ligamentous tissue;
   • disc degeneration or herniation; and/or
   • facet joint degeneration.

2. Has preoperative Oswestry score > 35.

3. Has no greater than Grade 1 spondylolisthesis utilizing Meyerding's Classification (Meyerding HW, 1932.).

4. Has single-level symptomatic degenerative involvement from L4 to S1.

5. Is at least 18 years of age, inclusive, at the time of surgery.

6. Has not responded to non-operative treatment (e.g., bed rest, physical therapy, medications, spinal injections, manipulation, and/or TENS) for a period of at least 6 months.

7. If female of child-bearing potential, who is not pregnant or nursing, and who agrees to use adequate contraception for 16 weeks following surgery.

8. Is willing and able to comply with the study plan and sign the Patient Informed Consent Form.

Exclusion Criteria

1. Had previous anterior spinal fusion surgical procedure at the involved level.
2. Has posterior spinal instrumentation (which will not be removed) stabilizing the involved level or has had a previous posterior lumbar interbody fusion procedure at the involved level.
3. Has a condition which requires postoperative medications that interfere with fusion, such as steroids or nonsteroidal antiinflammatory drugs (this does not include low dose aspirin for prophylactic anticoagulation or perioperative steroids).
4. Has osteopenia, osteoporosis, or osteomalacia to a degree that spinal instrumentation would be contraindicated.
5. Has presence of active malignancy or prior history of malignancy (except for basal cell carcinoma of the skin).
6. Has overt or active bacterial infection, either local or systemic.
7. Is obese, i.e., weight greater than 40% over ideal for their age and height.
8. Has fever (temperature> 101°F oral) at the time of surgery.
9. Is mentally incompetent. If questionable, obtain psychiatric consult.
10. Has a Waddell Signs of Inorganic Behavior score of 3 or greater.
11. Is a prisoner.
12. Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug abuse.
13. Is a tobacco user at the time of surgery.
14. Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal fusion surgery (e.g., steroids or methotrexate).
15. Has a history of autoimmune disease (Systemic Lupus Erythematosus or Dermatomyositis).
16. Has a history of exposure to injectable collagen implants.
17. Has a history of hypersensitivity to protein pharmaceuticals (monoclonal antibodies or gamma globulins) or collagen.
18. Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following rhBMP-2/ACS implantation.
19. Has received any previous exposure to any/all BMP's of either human or animal extraction.
20. Has a history of allergy to bovine products or a history of anaphylaxis.
21. Has history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers-Danlos syndrome, or osteogenesis imperfecta).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
rhBMP-2/ACS	rhBMP-2/ACS/allograft bone dowel	-
Autogenous Bone	Autogenous bone/allograft bone dowel	-

Primary Outcome Measures

Name	Time	Method
Overall success	24 month	A patient will be considered an overall success if all of the following conditions are met: 1. fusion; 2. pain/disability (Oswestry) improvement; 3. maintenance or improvement in neurological status; 4. no serious adverse event classified as implant associated or implant/surgical procedure associated; 5. no additional surgical procedure classified as a "failure."

Secondary Outcome Measures

Name	Time	Method
Back and Leg Pain Status (Numerical Rating Scale)	24 month
General Health Status (SF-36)	24 month
Patient Global Perceived Effect	24 month
Disc Height Measurement	24 month
Patient Satisfaction	24 month