A multicenter, prospective, non-randomized, historically controlled study. To 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 two levels from C3 to C7 are and are unresponsive to conservative management. Patients will be evaluated preoperatively, at the time of surgery, and at 6 weeks, and 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.
This is a research study comparing two ways of treating neck problems caused by degenerative disc disease (wear-and-tear damage to the discs that cushion the bones in the neck). The study is comparing: The Synergy Disc - an artificial disc device being studied in this trial, and Standard surgery (ACDF) - a widely used procedure called anterior cervical discectomy and fusion, which is the accepted current treatment. Up to 200 people will receive the Synergy Disc as part of this study. Their results will be compared to results from people who had the standard ACDF surgery in the past, rather than assigning some people to get ACDF during this study (this is called a "historical control"). The study takes place at multiple medical centers. Who this study is for: People who are fully grown (skeletally mature) and have damage in two neighboring discs in the neck (located somewhere between the C3 and C7 vertebrae). To qualify, a person's symptoms must include: Arm pain and/or nerve-related weakness or numbness (radiculopathy) that hasn't improved, and Neck pain or signs of spinal cord compression (myelopathy) These symptoms must be caused by problems in the two affected disc levels, and must not have gotten better with non-surgical treatment (such as physical therapy, medication, or injections). What the study will measure: Whether the Synergy Disc is as safe and effective as standard ACDF surgery for people who need surgery to relieve pressure on the nerves or spinal cord at two neighboring disc levels in the neck.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
200
Anterior cervical discectomy is a surgical procedure that was developed to treat damaged cervical discs by relieving pressure on the nerve roots or on the spinal cord by removing the ruptured disc. The operation is performed by reaching the cervical spine through a small incision in the front of the neck. The soft tissues of the neck are then separated allowing for the disc to be removed. Anterior cervical discectomy has proven to be a safe and effective procedure for the treatment of degenerative disc disease. The anterior approach allows direct visualization of the entire interspace and wide decompression of the anterior aspect cervical spinal cord and nerve roots. It may be undertaken in cases of multilevel disease and interbody fusion may be performed if required
HonorHealth
Scottsdale, Arizona, United States
Todd Lanman, MD
Beverly Hills, California, United States
DOCS Health Management LLC
Los Angeles, California, United States
Institute of Neuro Innovation
Santa Monica, California, United States
Steamboat Orthopaedic and Spine Institute
Steamboat Springs, Colorado, United States
Brain and Spine Center of South Florida
Delray Beach, Florida, United States
Kennedy-White Orthopaedic Center
Sarasota, Florida, United States
Indiana Spine Group
Carmel, Indiana, United States
Orthopedics Northeast
Fort Wayne, Indiana, United States
Precision Spine and Orthopaedic Associates, PA
Overland Park, Kansas, United States
...and 13 more locations
NDI
≥ 15-point improvement in NDI Score (out of 100) in subjects at 24 months compared with baseline
Time frame: 24 month
Standardized Neurological Assessment Scales
Maintenance or improvement in neurological status (motor and sensory only) at 24 months compared to baseline
Time frame: 24 month
Secondary Surgical Intervention
No study failure due to secondary surgical interventions (revision, removal, re-operation, supplemental fixation) at the index levels
Time frame: 24 month
Device Related Adverse Event
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-36
Health Survey (SF-36) at baseline and at each follow-up time-point
Time frame: pre-operative, 6 week, 3 month, 6 month, 12 month, 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: pre-operative, 6 week, 3 month, 6 month, 12 month, 24 month
Patient Satisfaction
Patient Satisfaction Questionnaire
Time frame: 6 week, 3 month, 6 month, 12 month, 24 month
BZ Score
Bazaz Dysphagia Score at 24 months compared to baseline
Time frame: 6 week, 3 month, 6 month, 12 month, 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 month, 6 month, 12 month, 24 month
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