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The purpose of this study is to compare Optecureâ„¢ as an autograft extender (treatment) to autograft alone (control) in patients undergoing 1 or 2 level fusion of the lumbar spine(one level is defined as two adjacent vertebrae), L2 and below.
The primary endpoint will be the assessment of fusion by evaluation of x-rays taken following surgery at each visit. The x-ray evaluation will be conducted by a radiologist who is blinded to the type of treatment each patient has received.
Subjects will be seen at 6 weeks, 3 months, 6 months, 12 months, and 24 months postoperative (post-op). Questionnaires and x-rays will be completed at each visit and a computed tomography (CT) scan will be taken at the 12 month visit(and used to aid in assessment of bridging bone, where appropriate).
Autograft (bone taken from one part of the body and placed in another site on the same individual) has long been considered the gold standard for lumbar spine fusion procedures. Unfortunately, there are complications involved with autograft harvest such as donor site morbidity, increased operating time, and limited supply. Therefore, the use of allograft (bone taken from one body and placed into another individual) as a graft extender has become an acceptable practice, especially in fusions of more than one level where larger quantities of graft material are needed.
In this study, comparisons will be made between patients who are randomized to having fusion with an allograft material (Optecure, Exactech, Inc.) mixed with an autograft to those patients who are randomized to having fusion with autograft alone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| O | Active Comparator | This treatment arm includes autograft harvested from local bone and / or the iliac crest, supplemented with a demineralized bone matrix (DBM) autograft extender, Optecure. |
|
| A | Active Comparator | This treatment arm includes autograft harvested from local bone and / or the iliac crest. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Posterior Lateral Fusion (PLF) | Procedure | Posterior lateral fusion (PLF) of the lumbar spine |
|
| Measure | Description | Time Frame |
|---|---|---|
| Radiographic evidence of fusion on x-rays taken at each post-op visit | Immediate post-op, 6-week, 3-month, 6-month, 1-year, 2-year |
| Measure | Description | Time Frame |
|---|---|---|
| Oswestry Disability Index (ODI) completed at each visit | pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year | |
| SF-12 patient health surveys completed at each visit | Pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Amir Fayyazi, MD | VSAS Orthopedics | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Memorial Orthopaedic Surgical Group | Long Beach | California | 90806 | United States | ||
| University of California, San Diego |
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| Anterior Lumbar Interbody Fusion (ALIF) | Procedure | Anterior lumbar interbody fusion (ALIF) |
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| Transforaminal lumbar interbody fusion (TLIF) | Procedure | Transforaminal lumbar interbody fusion (TLIF) |
|
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| Posterior lumbar interbody fusion (PLIF) | Procedure | Posterior lumbar interbody fusion (PLIF) |
|
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| Extreme lateral interbody fusion (XLIF) | Procedure | Extreme lateral interbody fusion (XLIF) |
|
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| Perceived pain noted on visual analog scales (VAS) at each visit | Pre-operative, 6-week, 3-month, 6-month, 1-year, 2-year |
| San Diego |
| California |
| 92103 |
| United States |
| Slocum Dickson Medical Group | New Hartford | New York | 13413 | United States |
| State University of New York, Upstate Medical University | Syracuse | New York | 13202 | United States |
| NeuroSpine Solutions, P.C. | Bristol | Tennessee | 37620 | United States |
| Madigan Army Medical Center | Tacoma | Washington | 98431 | United States |
| ID | Term |
|---|---|
| D003251 | Constriction, Pathologic |
| D013168 | Spondylolisthesis |
| D055959 | Intervertebral Disc Degeneration |
| ID | Term |
|---|---|
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D013169 | Spondylolysis |
| D055009 | Spondylosis |
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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