AzTrials
AzTrials

Degenerative Disc DiseasePhase 4NCT03077204

BIO4 Clinical Case Study: Cervical Spine

A Phase 4 study testing 1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window). and Aviator Anterior Cervical Plating System in people with Degenerative Disc Disease and Trauma (Including Fractures), run by Seton Healthcare Family at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The goal of this study is to investigate the efficacy of BIO4 bone matrix in patients undergoing 1 or 2-level Anterior Cervical Discectomy and Fusion (ACDF) spine surgery. Specifically, the study aims to collect the data for ACDF model utilizing BIO4 with Bio AVS Cervical Allograft (with graft window). Read more about this study

Who is it for?
Ages 19 years and older
What is being tested?
1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window). and Aviator Anterior Cervical Plating System
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
6 Apr 2017to 30 Jan 2020
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age>18 years
  • Scheduled 1 or 2-level ACDF spine surgery
  • The capacity to provide informed consent.
  • Subject has one or more of the following diagnoses:
  • Degenerative Disc Disease (as defined by neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies)
  • Trauma (including fractures)
Show all 28Show fewer
  • Tumors
  • Deformities or curvatures (including kyphosis, lordosis, or scoliosis)
  • Pseudoarthrosis
  • Failed previous fusion
  • Decompression of the spinal cord following total or partial cervical vertebrectomy
  • Spondylolisthesis
  • Spinal stenosis
  • Exclusion Criteria Patients with any of the following conditions will be excluded, or if enrolled and found to be ineligible and do not fit the inclusion criteria, will be withdrawn from the study.
  • Patients with current or recent history of malignancy or infectious disease.
  • The inability to provide informed consent.
  • Subject has marked local inflammation
  • Subject has any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
  • Subject has a bone stock compromised by disease, infection or prior implantation which cannot provide adequate support and/or fixation to the devices.
  • Subject has bone abnormalities preventing safe screw fixation.
  • Subject has any open wounds.
  • Subject has rapid joint disease, bone absorption, osteopenia, osteomalacia, and/or osteoporosis. Osteoporosis or osteopenia are relative contraindications, since this condition may limit the degree of obtainable correction and/or the amount of mechanical fixation.
  • Subject has a documented or suspected metal sensitivity.
  • Subject is pregnant.
  • Subject has anatomical structures or physiological performance that would interfere with implant utilization.
  • Subject has inadequate tissue coverage over the operative site.
  • Subject has other medical or surgical conditions which would preclude the potential benefit of surgery, such as congenital abnormalities, immunosuppressive disease, elevation of sedimentation rate unexplained by other diseases, elevation of white blood count (WBC), or marked left shift in the WBC differential count.
  • Note: The Aviator Anterior Cervical Plating System is not approved or intended for screw attachment to the posterior elements (pedicles) of the cervical, thoracic, or lumbar spine. The surgeon must consider the levels of implantation, patient weight, patient activity level, and other patient conditions which may impact on the performance of the system.

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Seton Spine and Scoliosis Center

    Austin, Texas, 78731

Other trials in United States

About this study

Official title: Clinical and Radiographic Outcomes of BIO4 Bone Matrix in Patients Undergoing 1 or 2-Level Anterior Cervical Discectomy and Fusion Surgery

The goal of this study is to investigate the efficacy of BIO4 bone matrix in patients undergoing 1 or 2-level Anterior Cervical Discectomy and Fusion (ACDF) spine surgery. Specifically, the study aims to collect the data for ACDF model utilizing BIO4 with Bio AVS Cervical Allograft (with graft window).

Read the detailed description

This is a prospective study with the intent to investigate the efficacy of BIO4 bone matrix in patients undergoing 1 or 2-level Anterior Cervical Discectomy and Fusion (ACDF) spine surgery. At the time a patient is scheduled for surgery, the patient's chart will be evaluated for inclusion/exclusion criteria. If a patient meets the criteria for the study, the study will be explained to the patient and consent obtained.

Investigators will utilize the BIO4 on label as a 361 HCT/P (human cell, tissue and cellular and tissue-based product) for homologous use for the repair, replacement or reconstruction of bone defects. Interbody fusion (1 or 2-level fusion) in conjunction with an allograft (hct/p) interbody spacer (anterior approach in the cervical spine with hardware) will be utilized.

Investigators will also use the Aviator Anterior Cervical Plating System for anterior intervertebral screw fixation of the cervical spine at levels C2-T1. The Aviator Anterior Cervical Plating System is intended for use as an aid in cervical spinal fusion and is intended for unilateral fixation. The Aviator plates are intended to be used with the Aviator bone screws.

Study Outcomes:

  • Radiological assessment (cervical spine x-ray and if needed, computed tomography (CT) at 1 year follow up)of fusion as the primary endpoint
  • Arthrodesis rates assessed using CT (1 year follow up, if needed) and Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays pre-operative (pre-op), post-operatively (post-op) 2~4 weeks (10~34 days post op), 3 months (83~97 days post-op), 6 months (173~187 days post-op) and 1 year post-op (351~379 days post op, primary data point outcome)
  • Revision rates
  • Outcome scores: Visual Analog Scale (VAS) and Neck Disability Index (NDI) pre-op, post-op 2~ 4weeks, 3 months, 6 months and 1 year.

The null hypothesis is that in ACDF model, the clinical and radiographic outcomes of utilizing BIO4 bone matrix with Bio AVS Cervical Allograft are equivalent to historical high level published data of similar product (Data reported in Meta-analysis ACDF obtained from FDA disc arthroplasty trials).

Being tested
1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window)., Aviator Anterior Cervical Plating System
Keywords
Total cervical vertebrectomy, Partial cervical vertebrectomy, Failed previous fusion, Spinal stenosis, Tumor, Decompression of the spinal cord, Pseudoarthrosis, Curvatures, Deformities
Medical subject headings
Intervertebral Disc Degeneration, Wounds and Injuries, Spondylolisthesis, Spinal Stenosis, Neoplasms, Pseudarthrosis, Congenital Abnormalities

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window).Biological

    The study will utilize the BIO4 on label as a 361 HCT/P (human cell, tissue and cellular and tissue-based product) for homologous use for the repair, replacement or reconstruction of bone defects. Interbody fusion (1 or 2-level fusion) in conjunction with an allograft (hct/p) interbody spacer (anterior approach in the cervical spine with hardware). Investigators will also use the Aviator Anterior Cervical Plating System for anterior intervertebral screw fixation of the cervical spine at levels C2-T1. The Aviator Anterior Cervical Plating System is intended for use as an aid in cervical spinal fusion and is intended for unilateral fixation. The Aviator plates are intended to be used with the Aviator bone screws.

  • Aviator Anterior Cervical Plating SystemDevice

    The study will utilize the BIO4 on label as a 361 HCT/P (human cell, tissue and cellular and tissue-based product) for homologous use for the repair, replacement or reconstruction of bone defects. Interbody fusion (1 or 2-level fusion) in conjunction with an allograft (hct/p) interbody spacer (anterior approach in the cervical spine with hardware). Investigators will also use the Aviator Anterior Cervical Plating System for anterior intervertebral screw fixation of the cervical spine at levels C2-T1. The Aviator Anterior Cervical Plating System is intended for use as an aid in cervical spinal fusion and is intended for unilateral fixation. The Aviator plates are intended to be used with the Aviator bone screws.

Study groups in NCT03077204
Study groupRoleWhat they receive
BIO4 treatmentOtherPatients undergoing 1 or 2-level Anterior Cervical Discectomy and Fusion (ACDF) spine surgery utilizing BIO4 with Bio AVS Cervical Allograft (with graft window).
Receives: Biological: 1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window).; Device: Aviator Anterior Cervical Plating System

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Radiological Assessment : Fusion Status

    This will be used to monitor the fusion status at 1 year post-op. The fusion states was reported as the number of patients who fused. If fused, then we say "Yes". We counted the number of patients who fused. If all 20 patients fused then we said there were 20 "yes".

    Measured: Post-op 1 year

  2. Arthrodesis Rates

    Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays will be used to access arthrodesis rates at different time intervals. We counted the number of patients who developed arthrodesis. The arthrodesis rate was calculated as the number of patients who developed arthrodesis.

    Measured: Post-op 1 year

Secondary outcomes (18)
  1. Revision Rates (if Any)

    As needed, any post-operative surgical revision rates will be accessed. The revision rate was described as the number of patients who had to undergo revision post index surgery

    Measured: Post-op 2~4 weeks

  2. Revision Rates (if Any)

    As needed, any post-operative surgical revision rates will be accessed. The revision rate was described as the number of patients who had to undergo revision post index surgery

    Measured: Post-op 3 months

  3. Revision Rates (if Any)

    As needed, any post-operative surgical revision rates will be accessed. The revision rate was described as the number of patients who had to undergo revision post index surgery

    Measured: Post-op 6 months

  4. Revision Rates (if Any)

    As needed, any post-operative surgical revision rates will be accessed. The revision rate was described as the number of patients who had to undergo revision post index surgery

    Measured: Post-op 1 year

  5. VAS

    Patient reported VAS will be collected at different time intervals. The revision rate was described as the number of patients who had to undergo revision post index surgery. VAS: 0-10 (0=better, 10=worst)

    Measured: Pre-op

  6. VAS

    Patient reported VAS will be collected at different time intervals. VAS: 0-10 (0=better, 10=worst)

    Measured: Post-op 2 ~ 4 weeks

  7. VAS

    Patient reported VAS will be collected at different time intervals. VAS: 0-10 (0=better, 10=worst)

    Measured: Post-op 3 months

  8. VAS

    Patient reported VAS will be collected at different time intervals. VAS: 0-10 (0=better, 10=worst)

    Measured: Post-op 6 months

  9. VAS

    Patient reported VAS will be collected at different time intervals. VAS: 0-10 (0=better, 10=worst)

    Measured: Post-op 1 year

  10. NDI

    Patient reported NDI will be collected at different time intervals. NDI: 0-100 (0=better, 100=worst)

    Measured: Pre-op

  11. NDI

    Patient reported NDI will be collected at different time intervals NDI: 0-100 (0=better, 100=worst)

    Measured: Post-op 2~4 weeks

  12. NDI

    Patient reported NDI will be collected at different time intervals. NDI: 0-100 (0=better, 100=worst)

    Measured: Post-op 3 months

  13. NDI

    Patient reported NDI will be collected at different time intervals. NDI: 0-100 (0=better, 100=worst)

    Measured: Post-op 6 months

  14. NDI

    Patient reported NDI will be collected at different time intervals. NSI: 0-100 (0=better, 100=worst)

    Measured: Post-op 1 year

  15. Arthrodesis Rates

    Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays will be used to access arthrodesis rates at different time intervals. The arthrodesis rate was calculated as the number of patients who developed arthrodesis.

    Measured: Pre-op

  16. Arthrodesis Rates

    Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays will be used to access arthrodesis rates at different time intervals. The arthrodesis rate was calculated as the number of patients who developed arthrodesis.

    Measured: Post-op 2~4 weeks

  17. Arthrodesis Rates

    Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays will be used to access arthrodesis rates at different time intervals. The arthrodesis rate was calculated as the number of patients who developed arthrodesis.

    Measured: Post-op 3 months

  18. Arthrodesis Rates

    Anterior-Posterior (AP), lateral and dynamic flexion-extension cervical spine x-rays will be used to access arthrodesis rates at different time intervals. The arthrodesis rate was calculated as the number of patients who developed arthrodesis.

    Measured: Post-op 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Mar 2017
  2. Study start6 Apr 2017
  3. Primary completion30 Jan 2020
  4. Study completion30 Jan 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03077204
Sponsor's protocol ID
CR-16-109
Status last verified
Dec 2021
First submitted
27 Feb 2017
Last updated
14 Jan 2022
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Roberts TT, Rosenbaum AJ. Bone grafts, bone substitutes and orthobiologics: the bridge between basic science and clinical advancements in fracture healing. Organogenesis. 2012 Oct-Dec;8(4):114-24. doi: 10.4161/org.23306. Epub 2012 Oct 1.

    PubMed 23247591
  • • Osiris Therapeutics-Data on File

  • • Bourke HE, Sandison A, Hughes SPF and Reichert ILH. Vascular Endothelial Growth Factor (VEGF) in Human Periosteum- Normal Expression and Response to Fracture, "Journal of Bone and Joint Surgery, British Volume (2003)

  • Epstein NE. An analysis of noninstrumented posterolateral lumbar fusions performed in predominantly geriatric patients using lamina autograft and beta tricalcium phosphate. Spine J. 2008 Nov-Dec;8(6):882-7. doi: 10.1016/j.spinee.2007.11.005. Epub 2008 Feb 14.

    PubMed 18280215
  • Epstein NE. Beta tricalcium phosphate: observation of use in 100 posterolateral lumbar instrumented fusions. Spine J. 2009 Aug;9(8):630-8. doi: 10.1016/j.spinee.2009.04.007. Epub 2009 Jun 4.

    PubMed 19501025
  • Eastlack RK, Garfin SR, Brown CR, Meyer SC. Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study. Spine (Phila Pa 1976). 2014 Oct 15;39(22):E1331-7. doi: 10.1097/BRS.0000000000000557.

    PubMed 25188591

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing 1 or 2-Level ACDF utilizing BIO4 with Bio AVS Cervical Allograft (with graft window). and Aviator Anterior Cervical Plating System in people with Degenerative Disc Disease and Trauma (Including Fractures), run by Seton Healthcare Family at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 28 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Jan 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Radiological Assessment : Fusion Status (time frame: Post-op 1 year). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03077204, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jan 2022.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in
BIO4 Clinical Case Study: Cervical Spine (NCT03077204) | AzTrials