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Trial was terminated prematurely due to receipt of CE mark
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This study will be a prospective, open-label, multi-center study that will collect safety data for the minimally invasive PerQdisc Nucleus Replacement Device deployed to reduce chronic low back pain.
This study will be a prospective, open-label, multi-center study that will collect safety data for the minimally invasive PerQdisc Nucleus Replacement Device (NRD). The NRD is used for surgical replacement of a single nucleus pulposus between spinal lumbar discs L1-S1 using an anterior or lateral transpsoas approach. Currently the surgical gold standard involves spinal fusion of the affected vertebral bodies, reducing range of motion and increasing stress on other vertebral bodies. The goal of nucleus replacement is to reduce chronic low back pain by maintaining disc height while preserving range of motion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nucleus Replacement | Experimental | All patients that meet the inclusion/exclusion criteria will receive the PerQdisc® Nucleus Replacement Device. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PerQdisc® Nucleus Replacement Device. | Device | All patients that meet the inclusion/exclusion criteria will receive the PerQdisc® Nucleus Replacement Device. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of revision surgery at the treated level | Number of patients requiring surgeries to revise the implanted level in the spine divided by the total number of implant surgeries. Express in percentage (0-100) | 90 days |
| Rate of expulsion | The rate of device expulsion. The number of patients determined to have expulsed devices divided by the total number of patients receiving implants.Expressed in percentage (0-100) | 90 Days |
| Rate of new herniation at the treated level as determined by MRI | Herniation will be determine by MRI. A herniation will be defined as violation of the intervertebral annulus, including expulsion of nucleus material. The response will be yes/no as assessed by the radiologist. Rate will be determined by total number of herniations divided by the total number of implanted devices. Expressed in percentage (0-100) | 90 days |
| Rate of new radiculopathy | New complaint of leg pain will be recorded as a yes/no response. Any complaint of new radiculopathy not seen preoperatively. Expressed as total number of new radiculopathy complaints divided by total number of patients. Expressed in percentage (0-100) | 90 days |
| MRI assessment of the endplate Modic changes. | Changes to vertebral endplates will be assigned based on Modic classification of I,II or III comparing preoperative grade to grade at 90 days. Possible scores are I,II or III | 90 days |
| Rate of surgical procedure technical success | The number of devices successfully implanted divided by the number of successfully devices implanted + unsuccessful implants. Output will be in percentage (0-100) |
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Inclusion Criteria:
Exclusion Criteria:
Intraoperative exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael Hess, MD | London Spine Clinic/ATOS-Klinik | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Onze Lieve Vrouw Ziekenhuis | Aalst | Belgium | ||||
| Montreal General Hospital |
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| ID | Term |
|---|---|
| D055959 | Intervertebral Disc Degeneration |
| D017116 | Low Back Pain |
| D001416 | Back Pain |
| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D010146 | Pain |
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This is an open label study. Patients that are unable to receive an implant due to intraoperative exclusion will receive standard of care
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| 90 days |
| Improvement in degree of disability as measured by the Oswestry Disability Index (ODI) | Change in absolute Oswestry Index score at 90 days compared to the preoperative score, range is 0-100 | 90 days |
| Improvement in back pain as measured by 10-centimeter Visual Analog Scale (VAS) | Change in the Visual Analogue Scale (VAS) for back and leg pain on a scale of 0-10 cm comparing preoperative scores to 90 days post-operative. | 90 days |
| Montreal |
| Quebec |
| H3G 1A4 |
| Canada |
| Clinical Hospital Dubrava | Zagreb | Croatia |
| Donauisar Klinikum Deggendorf | Deggendorf | 94469 | Germany |
| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |