A multicenter, prospective, non-randomized, historically controlled study. Demonstrate the Synergy Disc is at least as safe and effective as conventional anterior cervical discectomy and fusion (ACDF) to treat cervical degenerative disc disease (DDD) in subjects who are symptomatic at only one level from C3 to C7 that are unresponsive to conservative management. Patients will be evaluated preoperatively, at the time of surgery, and at 6 weeks, 3, 6, 12, and 24 months after surgery. Follow-up will continue annually until the last patient reaches 24-month follow-up. The primary analysis will occur at 24 months.
The proposed investigation is a prospective, non-randomized, multi-center, historically controlled comparison of the Synergy Disc to the control of conventional anterior cervical discectomy and fusion (ACDF) surgery in patients with cervical DDD. A total of 175 patients will be enrolled to the investigational group. The investigational group results will be compared to a historical control data from the ACDF control group, which utilized an identical study design. A statistically rigorous observational study design using propensity score (PS) subclassification will be used to demonstrate covariate balance and enhance the quality of inferences regarding effectiveness and safety relative to ACDF control. After investigational device enrollment is complete, but before most investigational device subjects have reached their 24-month endpoint, a data set containing only baseline covariates of prospectively enrolled investigational device patients and historical ACDF control patients will be constructed. The propensity score methods detailed below will be implemented by an outcomes-blinded statistician. A Propensity Score Memo summarizing the proposed observational design will be developed and submitted for review by stakeholders including FDA. The outcomes-blinded statistician will remain blinded until after consensus is achieved that the design is acceptable. This will allow for additional outcomes-blinded PS modeling if required. The objective of this clinical trial is to demonstrate the Synergy Disc is at least as safe and effective as conventional ACDF to treat cervical DDD in subjects who are symptomatic at only one level from C3 to C7 that are unresponsive to conservative management.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
175
ACDF
Barrow Brain and Spine
Phoenix, Arizona, United States
HonorHealth Research Institute/Barrow Brain and Spine
Scottsdale, Arizona, United States
Todd H. Lanman, M.D.
Beverly Hills, California, United States
Orthopedic Specialty Institute
Orange, California, United States
Institute of Neuro Innovation
Santa Monica, California, United States
Anschutz Medical Center
Aurora, Colorado, United States
Kennedy White Orthopaedic Center
Sarasota, Florida, United States
Indiana Spine Group
Carmel, Indiana, United States
Michigan Orthopedic Surgeons (2)
Southfield, Michigan, United States
Michigan Orthopedic Surgeons
Southfield, Michigan, United States
...and 10 more locations
NDI
≥ 15-point improvement in NDI Score (out of 100) in subjects at 24 months compared with baseline
Time frame: 24 Month
Neurological Assessment
Maintenance or improvement in neurological status (motor and sensory only) at 24 months compared to baseline
Time frame: 24 Month
SSI
No study failure due to secondary surgical interventions (revision, removal, re-operation, supplemental fixation) at the index level
Time frame: 24 Month
Device Related AE
Absence of major device related adverse events defined as radiographic failure, neurological failure, or failure by adverse event as adjudicated by the CEC.
Time frame: 24 Month
SF-3
Health Survey (SF-36) at baseline and at each follow-up time-point
Time frame: 6 Week, 3, 6, 12, and 24 Month
VAS
Visual analogue scale (VAS) will be used to evaluate pain where a change of at least 20mm will be considered clinically significant. Neck pain as measured on a 100mm VAS at baseline and at each follow-up time-point. Left and Right arm/shoulder pain as measured on a 100mm VAS at baseline and at each follow-up time-point. Please note, this assessment will include a "Worst" to pool together the left or right arm/shoulder scores with the higher baseline score. VAS Hoarseness on a 100mm scale.
Time frame: 6 Week, 3, 6, 12, and 24 Month
Patient Satisfaction
Patient Satisfaction Questionnaire
Time frame: 6 Week, 3, 6, 12, and 24 Month
BZ Score
Bazaz Dysphagia Score at 24 months compared to baseline
Time frame: 6 Week, 3, 6, 12, and 24 Month
Odom's Criteria
Results at 24 months for the investigational Synergy Disc and at 24 months for the control ACDF will also be categorized by the physician according to Odom's Criteria.
Time frame: 6 Week, 3, 6, 12, and 24 Month
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