The purpose of this investigation is to establish the safety and efficacy of the Biostat System when used for treatment of chronic low back (lumbar) pain due to symptomatic internal disc disruptions (IDD) by comparing safety and efficacy outcome measures between one group receiving BIOSTAT BIOLOGX® Fibrin Sealant through the Biostat® Delivery Device and another group receiving a preservative-free normal saline control delivered with the Biostat Delivery Device.
The Biostat System is a combination product combining a resorbable biologic product with a delivery device system used to prepare and insert the biologic material into a lumbar intervertebral disc. Symptomatic IDD is defined as a painful disruption of the internal architecture of a lumbar intervertebral disc, which appears as fissures, cracks or tears within the internal structures of the disc. Pain arising from a lumbar disc may not only be perceived as pain located in the low back (axial pain) but also as somatic referred pain involving the posterior hips, buttocks, lateral hips, groin, or posterior thighs. The diagnosis of symptomatic IDD cannot currently be made on the basis of imaging studies, physical examination, or symptoms alone, and is best established with meticulously conducted disc provocation studies (provocation discography) that include pressure manometry and identification of an adjacent normal disc. This treatment and study are not designed for patients exhibiting other potential sources of chronic low back pain such as more advanced degenerative disc disease with significant loss of disc height (\>33%), spinal stenosis, or spondylolisthesis (see Eligibility Criteria).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
220
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
One injection of up to 4 mL of saline using the Biostat Delivery Device
Alabama Clinical Therapeutics, LLC
Birmingham, Alabama, United States
HOPE Research Institute
Phoenix, Arizona, United States
Pain Control Associates of San Diego
Chula Vista, California, United States
Napa Pain Institute
Napa, California, United States
California Spine Diagnostics
San Francisco, California, United States
The Spine Institute
Santa Monica, California, United States
The Pain Institute, Inc
Merritt Island, Florida, United States
Millennium Pain Center
Bloomington, Illinois, United States
The Spine Center
Baltimore, Maryland, United States
Medical Advanced Pain Specialists Applied Research Center
Edina, Minnesota, United States
...and 10 more locations
Subject Composite Success
Subject success based on a composite of minimum 30% decrease in low back pain, 30% improvement in function, maintenance of neurological status, no secondary interventions, and no serious adverse events.
Time frame: 26 weeks
Visual Analog Scale for Low Back Pain
Percent of subjects achieving a minimum 30% decrease in pain from baseline. The visual analog scale is a horizontal 100 mm line anchored on the left with the words "No Pain" and on the right with the words "Worst Possible Pain". Scores were obtained by measuring the distance in millimeters from the left origin of the line (0) to the point indicated with a slash placed by the subject to indicate the subject's level of low back pain experienced over the last week.
Time frame: 26-weeks
Roland-Morris Disability Questionnaire Score
Percent of subjects achieving a minimum 30% decrease in Roland-Morris Disability Questionnaire score The Roland-Morris Disability Questionnaire is a widely studied and frequently used instrument for the assessment of function and disability related to low back pain. The questionnaire consists of 24 statements related to how a subject's back condition affects various activities of daily living. Subjects marked whether the statement either applied to them or did not apply at the time they responded to the statements. The score is the total number of questions with which the subject agreed. A higher score indicates less function and greater disability.
Time frame: 26-weeks
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