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The purpose of this study was to evaluate the rhBMP-2/CRM/CD HORIZON® Spinal System as a method of facilitating spinal fusion in patients with degenerative disc disease.
This clinical trial was conducted to evaluate the rhBMP-2/CRM/CD HORIZON® Spinal System for posterolateral fusion treatment of patients with symptomatic degenerative disc disease versus the control group of autogenous bone with the CD HORIZON® Spinal System.
The investigational treatment was the open bilateral posterolateral implantation of the rhBMP-2/CRM/CD HORIZON® Spinal System. One investigational implant was placed across two adjacent transverse processes on each side of the spine during the spinal fusion procedure.
The control treatment was the bilateral posterolateral implantation of the autogenous bone harvested from the iliac crest with the CD HORIZON® Spinal System.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Investigational | Experimental | Open bilateral posterolateral implantation of the rhBMP-2/CRM/CD HORIZON® Spinal System. |
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| Control | Active Comparator | The bilateral posterolateral implantation of the autogenous bone harvested from the iliac crest with the CD HORIZON® Spinal System. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rhBMP-2/CRM/CD HORIZON® Spinal System | Device | The rhBMP-2/CRM component of the investigational device consists of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) and a compression resistant matrix (CRM) carrier consisting of an absorbable collagen sponge imbedded with biphasic calcium phosphate. The posterior spinal fixation system, the CD HORIZON® Spinal System, is a commercially available rod-based spinal system intended for temporary stabilization of the spine in order to facilitate fusion. The CD HORIZON® Spinal System is available in either titanium or stainless steel. For this study, only titanium implant components will be used. |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Success | A patient will be considered an overall success if all of the following conditions are met:
| 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Fusion | Fusion is defined as:
| 24 months |
| Pain/Disability Status |
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Inclusion Criteria:
Each patient participating in this clinical trial must meet all of the following inclusion criteria:
Exclusion Criteria:
A patient meeting any of the following criteria is to be excluded from this clinical trial:
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| Name | Affiliation | Role |
|---|---|---|
| Kenneth Burkus, MD | The Hughston Clinic, P.C. | Principal Investigator |
| John Dimar, MD | Spine Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Barrow Neurosurgical Associates | Phoenix | Arizona | 85013 | United States | ||
| Orthopaedic Specialty Institute |
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| Autograft/CD HORIZON® Spinal System | Device | The control will be autogenous bone taken from the iliac crest of the patient and placed bilaterally across two adjacent transverse processes and used in conjunction with the CD HORIZON® Spinal System. When used as a posterior spine thoracic/lumbar system, the CD HORIZON® CANNULATED M8 MULTI-AXIAL SCREW components are intended for several indications including degenerative disc disease. |
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The self-administered Oswestry Low Back Pain Disability Questionnaire will be used. Success will be defined as pain/disability improvement postoperatively according to the definition: Preoperative Score - Postoperative Score >= 15 points
| 24 months |
| Overall Neurological Status | Neurological status will be assessed preoperatively and postoperatively using a neurological status scale. Neurological status is based on four types of measurements (sections): motor, sensory, reflexes, and straight leg raise. Overall measure of neurological status will be based on success statuses in the four parameters. | 24 months |
| General Health Status | The Medical Outcomes Study 36-item Short Form Health Survey (SF-36) will be used to assess general health status. The SF-36 results can be summarized into two components, a physical component summary (PCS) and a mental component summary (MCS). Success will be defined as a maintenance or improvement in status postoperatively as compared to the preoperative condition. To be classified as a success, the following criteria must be met: PCSPostop - PCSPreop >= 0; MCSPostop - MCSPreop >= 0 | 24 months |
| Back Pain | Numerical rating scales will be used to evaluate pain intensity and duration. The pain score (0 min, 20 Max) is derived by adding the numerical rating scores from the pain intensity (0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be.") and duration scales (0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time"). Success for back and leg pain is described as follows: Preoperative Score - Postoperative Score >=0 | 24 months |
| Leg Pain | Numerical rating scales will be used to evaluate pain intensity and duration. The pain score (0 min, 20 Max) is derived by adding the numerical rating scores from the pain intensity (0-10, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be.") and duration scales (0-10, with a score of 0 being "pain none of the time" and a score of 10 being "pain all of the time"). Success for back and leg pain is described as follows: Preoperative Score - Postoperative Score >=0 | 24 months |
| Operative Time | At the time of operation |
| Blood Loss | At the time of operation |
| Hospital Days | At the time of discharge |
| Orange |
| California |
| 92868 |
| United States |
| UCLA Orthopedic Hospital | Santa Monica | California | 90404 | United States |
| Georgetown University Dept. of Orthopaedic Spine Surgery | Washington D.C. | District of Columbia | 20007 | United States |
| Brevard Orthopaedic Clinic, Inc. | Melbourne | Florida | 32901 | United States |
| Florida Ortho Institute | Tampa | Florida | 33637 | United States |
| Florida Neurological Consultants | Winter Park | Florida | 32789 | United States |
| The Hughston Clinic P.C. | Columbus | Georgia | 31908 | United States |
| Barrington Orthopedic Specialists | Hoffman Estates | Illinois | 60195 | United States |
| Lutheran Spine Center | Park Ridge | Illinois | 60068 | United States |
| The Spine Institute | Carmel | Indiana | 46032 | United States |
| University of Iowa Hospitals & Clinics | Iowa City | Iowa | 52241 | United States |
| Des Moines Orthopaedic Surgeons | West Des Moines | Iowa | 50266 | United States |
| Spine Institute | Louisville | Kentucky | 40202 | United States |
| Alvin & Lois Lapidus Cancer Insitute | Baltimore | Maryland | 21215 | United States |
| Jeffrey S. Fischgrund | Southfield | Michigan | 48034 | United States |
| Orthopedic Spine Care of Long Island, PC | Melville | New York | 11747 | United States |
| Beth Israel Medical Center | New York | New York | 10003 | United States |
| Duke University Hospital | Durham | North Carolina | 27710 | United States |
| Central States Orthopedic Specialists | Tulsa | Oklahoma | 74136 | United States |
| Medford Neurological & Spine Clinic | Medford | Oregon | 97504 | United States |
| The Reading Neck & Spine Center | Wyomissing | Pennsylvania | 19610 | United States |
| East Tennessee Brain & Spine | Johnson City | Tennessee | 37604 | United States |
| Fort Worth Brain & Spine | Fort Worth | Texas | 76104 | United States |
| Brain and Spine Center of Texas | Plano | Texas | 75093 | United States |
| Azalea Orthopedic & Sports Medicine Clinic | Tyler | Texas | 75701 | United States |
| University of Utah | Salt Lake City | Utah | 84132 | United States |
| UVA Dept. of Neurosurgery | Charlottesville | Virginia | 22908 | United States |
| ID | Term |
|---|---|
| D055959 | Intervertebral Disc Degeneration |
| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D014182 | Transplantation, Autologous |
| ID | Term |
|---|---|
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |
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