NCT00749060已完成不适用
Prospective Randomized Comparative Study of Balloon Kyphoplasty,Vertebroplasty and Conservative Management in Acute Osteoporotic Vertebral Fractures of Less Than 6 Weeks
适应症
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 2
- 主要终点
- Change in Vertebral Kyphotic angle between preoperative and one-year follow-up measurements.
研究概览
简要总结
This study aims to compare three treatments in recent (less than 6 week duration) non-traumatic ( usually osteoporotic) vertebral fractures.
详细描述
The three treatments are the following: 1/Conventional medical treatment including rest and pain medications2/Vertebroplasty consisting in the percutaneous injection into the fractured vertebra of polymethylmetacrylate cement (the cement used to fix prosthesis in joint replacement) through a posterior route through the vertebral pedicles under radiological guidance.3/Balloon Kyphoplasty which consists of placing through a percutaneous posterior approach under radiological guidance, into the fractured vertebra a balloon which is inflated with fluid and creates a cavity. This may restore part of the vertebral height loss due to the fracture. In addition, after balloon deflation, polymethylmetacrylate cement may be injected with low pressure into the created cavity. The study will indicate if balloon kyphoplasty is able to restore vertebral height of the fractured vertebra better than medical treatment and vertebroplasty.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient is able to undergo the vertebroplasty or Balloon kyphoplasty procedure
- •Patient must have signed the consent form (ZELEN Randomization protocol)
- •Male or female, 50 years or older
- •One or two non-traumatic vertebral fracture(s):
- •Of osteoporotic origin (low speed trauma such as fall from his own height or less than 80 cm)
- •Fracture(s) of less than 6 weeks duration after the onset of pain related to the fracture The fracture(s) exhibit(s) high signal intensity on T2-weighted images and a benign appearance at MRI
- •The patient will be able to receive the selected protocol treatment within 6 weeks after onset of fracture-related symptoms and within 15 days after treatment randomization.
- •The benign nature of the vertebral fracture has to be confirmed by the results of the biopsy performed during vertebroplasty or balloon kyphoplasty or by one year follow-up in the conservative treatment group.
排除标准
- •Patient with a vertebral fracture of more than 6 week duration after onset of fracture-related symptoms.
- •Neurological signs related to the vertebral fracture to treat
- •History of surgical or percutaneous spine treatment except simple discectomy at a single or multiple vertebral levels with no residual pain.
- •More than two recent vertebral fractures
- •Current infection
- •Impossibility to perform the percutaneous approach of the vertebra to treat.
- •Reduction by more than 50% of the anteroposterior width of the bony spinal canal due to the vertebral fracture to treat.
- •Known allergy to a contrast media or to one of the cement components used for kyphoplasty.
- •Vertebral fracture with loss of 90%or more of the vertebral body height
- •Neurological signs or symptoms related to the vertebral fracture
- •Malignant and traumatic vertebral fractures
- •Contraindication to MRI :
- •Metallic implant : pace-maker, non movable auditive implant, metallic vascular or cardiac device
- •Metallic surgical clips
- •Claustrophobia
- •Evolutive cardiac disease nonreactive to medical treatment
- •Patient presenting a non correctable spontaneous or therapeutic coagulation disorder.
- •Presence of an unexplained biological inflammatory syndrome with NFS≥20
- •Non compliant patient: Impossibility to participate to the study and to be followed up for 1 year.
- •Pregnant or breast feeding women
- •Patient not affiliated to social security
结局指标
主要结局
Change in Vertebral Kyphotic angle between preoperative and one-year follow-up measurements.
时间窗: 1 year
次要结局
- 1° - Pain evaluation using a visual analogic scale(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Analgesics intake according to the WHO classification (Classes 1, 2 and 3).(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Quality of life evaluation (QUALEFFO - Short-Form SF12).(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Regional spine Kyphosis angle and global thoracic and lumbar Kyphosis angle(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Intensity of signal with T2 sequence(preoperative and at J360)
- Changes in anterior, mid and posterior vertebral heights of the treated vertebral body(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Changes in height of the intervertebral disc spaces adjacent to the treated vertebra(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- questionnaire (Eifel) for back pain evaluation(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Number of new vertebral fractures occurring during the one year follow-up period(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
- Follow-up of anterior, median and posterior height of the treated vertebral body, obtained by making an average of all measurements, on 3 cuts tomodensitometry (tdm) on the sagittal level : lateral right, median and lateral left(preoperative, at J6 and at J360)
- Cost evaluation in a sample of 10% of patients randomly selected including the following costs : o Intervention cost. o Medical treatment costs o Consultation costs. o Hospitalization cost o Complication costs(J-20 à J-7 / J6 / J45 /J90 /J180 / J360)
研究者
研究点 (2)
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