This is a global, multi-center, prospective, randomized, blinded, controlled pivotal study. Clinical and radiological evaluation will be performed preoperatively and postoperatively up to 24 months; and endpoint success will be determined at 24 months postoperatively. Overall a maximum of 600 subjects will be enrolled and treated. The purpose of the study is to provide safety and effectiveness data of Infuse™ in Transforaminal Lumbar Interbody Fusion (TLIF) procedures and to obtain indication expansion for Infuse™ use in one and two level TLIF procedures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
600
(Recombinant human bone morphogenetic protein-2 (rhBMP-2)/absorbable collagen sponge (ACS))
Adaptix™Interbody System, Capstone™ Spinal System, Catalyft™ PL Interbody System
Overall success at 24 months
Overall success is defined as the participant who meet the following five criteria: * Pain/disability (ODI) success, defined as at least a 15-point improvement from baseline; * Fusion success as defined in primary outcome 2. * Neurological success, defined as maintenance or improvement in neurological status; * No SAE related to the TLIF grafting material or interbody device; and * No secondary surgeries at index level that are related to the TLIF grafting material or interbody device
Time frame: 24 months
Fusion success at 24 months
Fusion success at each treatment level must demonstrate: * Evidence of bridging bone via CT. Solid fusion is based on evidence of continuous bone bridging from the superior to the inferior vertebral body at the target level(s) in at least 1 of the following locations: right lateral, left lateral, anterior, posterior, or through the intervertebral body fusion device. * No evidence of motion as defined by less than 2 mm translational motion and less than 3° in angular motion at each treated level (flexion/extension radiographs).
Time frame: 24 Months
Time to fusion
The first time point when a subject's fusion status has been determined to be a success per the fusion success criteria
Time frame: From surgery to 24 Months
ODI success
The self-administered Oswestry Disability Index (ODI) will be used. The ODI scale ranges from 0-100. The best score is 0 (no disability) and worst is 100 (maximum disability). Success will be defined as pain/disability improvement postoperatively according to the following definition: Preoperative Score - Postoperative Score ≥ 15 points
Time frame: 24 months
Leg pain success
Numerical rating scales (NRS 0-10) will be used to measure leg pain, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be. Success for leg pain is defined as at least 30% improvement from pre-operative score: (Preoperative Score - Postoperative Score) / Preoperative Score ≥ 30%
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Mayo Clinic
Phoenix, Arizona, United States
University of Arizona
Tucson, Arizona, United States
University of California Irvine
Irvine, California, United States
Memorial Health Services
Laguna Hills, California, United States
Cedars Sinai Spine Center
Los Angeles, California, United States
University of California Davis Medical Center
Sacramento, California, United States
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Boulder Neurosurgical Associates and Justin Parker Neurological Institute/E. Lee Nelson
Boulder, Colorado, United States
Vail-Summit Orthopaedics and Neurosurgery
Vail, Colorado, United States
Hartford Hospital
Hartford, Connecticut, United States
...and 36 more locations
Time frame: 24 months
Back pain success
Numerical rating scales (NRS 0-10) will be used to measure back pain, with a score of 0 representing "no pain" and a score of 10 representing "pain as bad as it could be". Success for back pain is defined as at least 30% improvement from pre-operative score: (Preoperative Score - Postoperative Score) / Preoperative Score ≥ 30%
Time frame: 24 months
Neurological success
Overall neurological success is defined as maintenance or improvement in four key neurological assessments: motor function, sensory function, reflexes, and straight leg raise. In order to be considered a success, each element in the motor, sensory, reflexes, and straight leg raise examinations must remain the same or improve from the time of the preoperative evaluation to the time period evaluated. Therefore, if any one motor, sensory, or reflexes element does not stay the same or improve, then a subject will not be considered a success for neurological status.
Time frame: 24 months
Serious Adverse Events
Serious Adverse Events related to TLIF grafting material or interbody device up to 24 months
Time frame: up to 24 months
Secondary Surgery
Secondary surgeries that are classified as a "failure", defined as any secondary surgeries at index level(s) "related" to TLIF grafting material or interbody device.
Time frame: up to 24 months