The aim of this study is to demonstrate the safety and effectiveness of the Lobster interspinous spacer device for the treatment of Lumbar Spinal Stenosis in comparison to an SSED-based performance goal.
After being informed about the study and potential risks, patients with Lumbar Spinal Stenosis matching inclusion and exclusion criteria giving written informed consent will undergo Lobster device implantation and followed-up for 2 years for radiological and clinical assessment in a single-arm, prospective, multicentric clinical trial.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
210
The intervention is performed percutaneously using the dedicated instrument set.
SS. Trinità - Reparto di Radiologia
Cagliari, Sardinia, Italy
RECRUITINGEffectiveness of the Lobster device in comparison to an SSED-based performance goal (PG)
Efficacy success will be evaluated as a two-prong composite endpoint: * ZCQ Responder (at least two of the three ZCQ domains) * ≥0.5 point improvement in physical function * ≥0.5 point improvement in symptom severity * Mean satisfaction ≤2.5 points * No secondary surgical intervention (SSI) including re-operations, revision, removals or supplemental fixation or clinical significant confounding treatments (i.e., epidural steroid injections at the index level, spinal cord stimulators or rhizotomies) through 12 months
Time frame: 12 months
Safety of the Lobster device in comparison to an SSED-based performance goal (PG)
Safety success will be evaluated using precision-based statistics to characterize the incidence of major device- or procedure-related complications, including: * Device integrity failure (dislodgement, migration, or deformation) * New or persistent worsened neurological deficit at the index level * Spinous process fractures * Deep infection, death, or other permanent device attributed disability
Time frame: 12 months
Oswestry disability index (ODI)
Oswestry disability index. Patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. Min. value 0 (better outcome) Max. value 100 (worst outcome)
Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months
Visual Analogue Scale (VAS)
VAS (Pain regarding Back and Leg) Min. value 0 (better outcome) Max. value 10 (worst outcome)
Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months
Short Form SF-12
SF-12 Short Form Survey (Physical Function and Mental Health). The SF-12 is a self-reported outcome measure assessing the impact of health on an individual's everyday life. It is often used as a quality of life measure. Min. value 0 (worst outcome) Max. value 100 (better outcome)
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Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months
Zurich Claudication Questionnaire (ZCQ)
The questionnaire consists of three domains and uses a Likert-type scale. It includes 7 items for symptom severity with scores of 1 to 5, 5 items for functional disability with scores of 1 to 4, and 6 items for treatment satisfaction with score of 1 to 4. Higher scores indicate more severe LSS.
Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months
Number of participants with abnormal Neurological examination findings
Neurological examination to assess and identify any abnormalities that affect function and activities of daily living. Electromyography is performed at the discretion of the investigator.
Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months
Radiological status
An independent radiographic core laboratory will be used to provide an unbiased assessment of all x-rays and CT scans (pre-procedure through last follow-up assessment). All images will be evaluated in accordance with the Image Review Charter which is provided to the sites. Radiographic evaluations include: * Angular Range of Motion * Translational Motion * Device Condition * Device Migration * Device Dislodgement * Bone-Implant Interface Changes * Exuberant Bone Formation
Time frame: Pre-treatment, 6 weeks, 3 months, 6 months, 12 months, 24 months