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The purpose of this prospective, single-arm, multicenter study is to assess an annular closure device when used as an adjunct to a primary lumbar limited discectomy, to limited discectomy alone.
This single-arm case series will enroll 75 patients at select US (approximately 8-10) sites. Patients that are scheduled for a single-level L4-S1 discectomy and who meet the pre-operative eligibility criteria will be considered for study participation. Patients that meet all intraoperative criteria will be enrolled into the study and treated with lumbar discectomy and additional annular closure device implantation. All enrolled subjects will be followed for at least 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Annular closure device | Other | Single arm study; all patients treated with an annular closure device |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Annular closure device | Device | Annular closure, following limited discectomy procedure at a single LS level between L4 and S1 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood loss | Amount of blood loss measured in ml | Intra-operative |
| Procedure time | Length of surgery, measured in minutes | Intra-operative |
| Hospital stay | Length of the hospital stay measured in days between hospital admission and hospital discharge | Post-procedure hospital discharge day (in average between 1 and 3 days post surgery) |
| Discharge status | Evaluation of improvement in motor and sensory neurologic status | Post-procedure hospital discharge day (in average between 1 and 3 days post surgery) |
| Leg pain severity (0-100 VAS score) | Change from baseline of Visual Analogue Scale score (values between 0-100), with lower values representing better outcome | Baseline, 4 Weeks, 3 Months, 1 year |
| Back pain severity (0-100 VAS score) | Change from baseline of Visual Analogue Scale score (values between 0-100), with lower values representing better outcome | Baseline, 4 Weeks, 3 Months, 1 year |
| ODI | Change from baseline in Oswestry Disability Index. The ODI is scored on a scale from 0% to 100%, with higher scores indicating higher levels of disability | Baseline, 4 Weeks, 3 Months, 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David H Kim, MD | New England Baptist Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UC San Diego Health System | San Diego | California | 92037 | United States | ||
| Baptist - Lyerly Neurosurgery |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31464935 | Derived | Strenge KB, DiPaola CP, Miller LE, Hill CP, Whitmore RG. Multicenter study of lumbar discectomy with Barricaid annular closure device for prevention of lumbar disc reherniation in US patients: A historically controlled post-market study protocol. Medicine (Baltimore). 2019 Aug;98(35):e16953. doi: 10.1097/MD.0000000000016953. |
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| ID | Term |
|---|---|
| D007405 | Intervertebral Disc Displacement |
| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006547 | Hernia |
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| EQ-5D | Change from baseline in EQ-5D. The EuroQol (EQ-5D) is a generic utility measure used to characterize current health states. The subject-reported questionnaire consists of 5 domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each of which can take one of three responses. Possible responses include three levels of severity (no problems/some or moderate problems/extreme problems) within a particular EQ-5D dimension | Baseline, 4 Weeks, 3 Months, 1 year |
| Satisfaction with surgery procedure | Patient satisfaction with surgery and treatment assessed utilizing questionnaire with Composite questionnaire with 2 questions will be administered; 1.) Indicate degree of satisfaction with the outcome and 2.) likelihood of recommending the procedure to others | 1 year |
| Neurological assessment | Change from baseline in sensory (sensation response at dermatomal levels) reflex, (knee jerk, ankle jerk, response measured as "normal", "increased", "absent" and "decreased") and muscle strength measured 0-5 with "0" representing no evidence of motor strength and "5" representing full resistance | Baseline, 4 Weeks, 3 Months, 1 year |
| Adverse events | Change of health status with occurrence of adverse event, reported by seriousness and relationship to the device or procedure | Baseline, Intra-operative, 4 Weeks, 3 Months, 1 year |
| Hospital readmission occurrence | Change from baseline in incidence of re-admissions to hospital, post treatment | Post-procedure hospital discharge day (in average between 1 and 3 days post surgery), 4 Weeks, 3 Months, 1 year |
| Symptomatic reherniation incidence | Change from baseline in incidence of post-operative recurrent herniation at the index level. Recurrent herniation may be confirmed surgically, or radiographically as determined by an independent review | Post-procedure hospital discharge day (in average between 1 and 3 days post surgery), 4 Weeks, 3 Months, 1 year |
| Reoperation incidence | Change from baseline in incidence of post-operative reoperation at the index level | Post-procedure hospital discharge day (in average between 1 and 3 days post surgery), 4 Weeks, 3 Months, 1 year |
| Return to work assessment | Change from baseline in work status (ability to return to work, with or without reported restrictions) | 4 Weeks, 3 Months, 1 year |
| Opioid consumption | Change from baseline for all opioid based medications (routes of administration (oral, IV, transdermal), dosing (mg/ml/tablet), duration (days)). | Baseline, Intra-operative, Post-procedure hospital discharge day (in average between 1 and 3 days post surgery), 4 Weeks, 3 Months, 1 year |
| Jacksonville |
| Florida |
| 32207 |
| United States |
| North Shore University Health System | Evanston | Illinois | 60201 | United States |
| Indiana Spine Group | Carmel | Indiana | 46032 | United States |
| Orthopaedic Institute of Western Kentucky | Paducah | Kentucky | 42001 | United States |
| Louisiana Spine Institute | Shreveport | Louisiana | 71101-4643 | United States |
| Salt Lake Orthopaedic Clinic | Salt Lake City | Utah | 84124 | United States |
| D020763 |
| Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |