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Cervical DeformityPCD 2NCT04194996

Radiographic and Clinical Evaluation of Surgical Treatment for Cervical Deformity: A Multi-Center Study 2.0

An observational study of Cervical Deformity, run by International Spine Study Group Foundation at 16 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Multi-center, prospective, non-randomized study to evaluate outcomes of surgically treated patients with adult cervical spinal deformity. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cervical Deformity
What is being tested?
Surgical intervention
Type of treatment
Surgery or procedure
How many people
200 participants
Where
16 sitesUnited States
Study dates
1 Aug 2019to 31 Jul 2030
Phase
Observational
Are there results?
Not yet: the study is under way

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

Study population: Spine Surgeon Clinic

Who may be able to join

  • ≥18 years old at time of treatment
  • Diagnosis of cervical deformity- must meet one or more of the following criteria:
  • C2-C7 sagittal kyphosis (Cobb > 15 degrees)
  • T1S-CL > 35o
  • Segmental cervical kyphosis > 10 degrees between any 2 vertebra between C2-T1 or > 15 degrees across any 3 vertebra between C2-T1
  • Cervical scoliosis > 10 degrees (Cobb angle must include end vertebra within the cervical spine)
Show all 14Show fewer
  • C2-C7 SVA > 4cm
  • McGregor's slope > 20 degrees or CBVA > 25 degrees OR
  • Planned Revision surgery for proximal junctional failure with an anticipated UIV in the cervical spine and an anticipated LIV in the thoracic or lumbar spine.
  • Plan for surgical correction of cervical deformity in the next 6 months
  • Willing to provide consent and complete study forms at baseline and follow-up intervals
  • Upright AP/Lateral entire spine (EOS or 36")
  • Upright AP/Lateral C spine ONLY IF C spine is not completely visible on entire spine films
  • Flex/Ext lateral C spine. Admin may allow exceptions w/ valid documentation.

Who cannot join

  • Active spine tumor or infection
  • Deformity due to acute trauma
  • Unwilling to provide consent or to complete study forms
  • Prisoner
  • Pregnant or immediate plans to get pregnant

Trial locations and contacts

16 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Christine Baldus, MS contact

6184444130

baldusc@wustl.edu

Ray Pinteric contact

ray.pinteric@outlook.com

16 sites in 1 country

United States16 sites, 13 recruiting
  • University of Michigan, Department of Neurosurgery

    Ann Arbor, Michigan, 48109

    Completed
  • Johns Hopkins University, Department of Neurological Surgery

    Baltimore, Maryland, 21224

    Ahmed Sulieman, asuliem2@jh.edu

    Khaled Kebaish, MD

    Recruiting
  • University of Virginia

    Charlottesville, Virginia, 22908

    Lorrie Sipe, 434-924-8775, lag3k@virginia.edu

    Justin Smith, MD

    Recruiting
  • Rush University, Department of Neurosurgery

    Chicago, Illinois, 60612

    Withdrawn
  • Medical City Spine Hospital - Southwest Scoliosis Institute

    Dallas, Texas, 75243

    Mona Hedra, MD, 214-663-5622, Mona.Hedra@HCAhealthcare.com

    Richard Hostin, MD

    Recruiting
  • Denver International Spine Center, Rocky Mountain Hospital for Children and Presbyterian St. Luke's Medical Center

    Denver, Colorado, 80128

    Breton Line, BS, 303.762.3472, breton.line@gmail.com

    Shay Bess, MD

    Recruiting
  • Duke University Health System

    Durham, North Carolina, 27708

    Ronald Pegues, ronald.pegues@duke.edu

    Christopher I Shaffrey, MD

    Recruiting
  • University of Kansas Medical Center, Department of Orthopedic Surgery

    Kansas City, Kansas, 66160

    Dave Turkowitch, dturkowitch@kumc.edu

    Brandon Carlson, MD

    Recruiting
  • Shiley Center for Orthopaedic Research and Education at Scripps Clinic

    La Jolla, California, 92037

    Paulina de la Garza, 858-554-7124, delaGarza.Paulina@scrippshealth.org

    Roslyn Kackman, Kackman.Roslyn@scrippshealth.org

    Recruiting
  • Leatherman Spine Center, Department of Orthopedic Surgery

    Louisville, Kentucky, 40202

    Morgan Brown, morgan.brown2@nortonhealthcare.org

    Jeffrey Gum, MD

    Recruiting
  • Hospital for Special Surgery, Department of Orthopedic Surgery

    New York, New York, 10003

    Christopher Yoo, yooch@hss.edu

    Han Jo Kim, MD

    Recruiting
  • New York University, Department of Orthopedic Surgery

    New York, New York, 10003

    Connie Maglaras, constance.maglaras@nyulangone.org

    Themistocles Protopsaltis, MD

    Recruiting
  • Columbia University Medical Center

    New York, New York, 10032

    Meghana Vulapalli, mv2748@cumc.columbia.edu

    Daniel K Riew, MD

    Recruiting
  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15219

    Lauren Puccio, pucciolm@upmc.edu

    Thomas Buell, MD

    Recruiting
  • University of California Davis, Department of Orthopedic Surgery

    Sacramento, California, 95817

    Active, not recruiting
  • University of California-San Francisco Medical Center

    San Francisco, California, 94143

    Adrian Fu, 925-202-9682, Adrian.Fu@ucsf.edu

    Christopher Ames, MD

    Recruiting

Other trials in United States

About this study

Official title: Prospective Radiographic and Clinical Evaluation of Surgical Treatment for Cervical Deformity: A Multi-Center Study 2.0

Multi-center, prospective, non-randomized study to evaluate outcomes of surgically treated patients with adult cervical spinal deformity.

Read the detailed description

Adult cervical deformity (ACD) is an uncommon but potentially severely debilitating condition with a broad range of causes that include but are not limited to spondylosis, inflammatory arthropathy, trauma, infection, iatrogenic, neoplastic, congenital, and neuromuscular processes. In general, sagittal plane deformities typically produce kyphosis, and coronal plane deformities result in scoliosis. Cervical kyphotic deformities are most commonly encountered in the setting of prior surgical destabilization, while cervical scoliosis is most commonly associated with congenital and neuromuscular conditions.

Cervical kyphosis may be progressive and can result in neurological symptoms, including myelopathy. The most severe forms, such as those associated with spondylotic arthropathies, can produce "chin-on-chest" deformity, which can compromise horizontal gaze, swallowing, and breathing. Even in the absence of these conditions, cervical deformity is often associated with pain and functional disability. For adult thoracolumbar deformities, substantial efforts have been made to characterize clinical presentations, develop standardized classification systems, define optimal treatment approaches, describes operative complication rates, and to present structured clinical outcomes. However, despite the potential for profound impact of cervical deformity on function and health-related quality of life, there remains a remarkable paucity of high-quality studies that address these complex conditions.

Health professionals providing nonoperative and surgical care for these patients are left to make important treatment decisions based on a combination of personal experience, anecdotal experience of colleagues and experts, and relatively small, often single-surgeon or single-center, retrospective case reports or case series in the literature. Recent systematic reviews have high-lighted the lack of studies relevant to cervical deformity and have failed to identify any prospective studies.

The International Spine Study Group (ISSG) consists of orthopedic and neurological spine surgeons with a practice emphasis on spinal deformity patients. These surgeons, from 12 busy surgical centers, meet regularly to design and perform clinical research focused on spinal deformity, including successful prospective enrollment of more than 1,000 adult thoracolumbar deformity patients into the ISSG database. This group has a proven track record and regularly presents a substantial number of abstracts to the major spine meetings and has an extensive publication record.

The ISSG members have currently enrolled more than 150 patients into the first generation prospective cervical deformity database and have produced approximately 50 abstracts and more than 25 manuscripts to date with the resulting data. The group has learned extensively from this first-generation database, but there is much yet to learn, as the literature remains relatively sparse on the topic of adult cervical deformity. Based on what we have learned from the first generation database; we have substantially modified the inclusion criteria for this second generation database. In addition, several new outcomes measures and functional assessments will be collected at baseline and follow-up intervals as part of this current proposal.

The resources of the ISSG offer an unprecedented opportunity to create a prospectively collected multicenter database of cervical deformity patients that includes standardized health-related quality of life measures at baseline and regular follow-up, clinical and surgical parameters, and complications. The database and questionnaires have been carefully redesigned based on what we have learned in order to better collect data that will help to clarify many of the unresolved issues that are important for the care of cervical deformity patients. This project has substantial potential to significantly impact the field of cervical deformity and the care of deformity patients beyond what we have already been able to accomplish based on the first generation cervical deformity database. Herein we propose the second iteration for this project that promises to further advance our evolving understanding of these complex deformities.

Being tested
Surgical intervention
Keywords
Cervical deformity, Kyphosis, Scoliosis
Medical subject headings
Kyphosis, Scoliosis

What participants receive

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

  • Surgical interventionProcedure or surgery

    Surgical interventions will be patient specified by treating surgeon.

Study groups in NCT04194996
Study groupRoleWhat they receive
OperativeInclusion criteria: 1. ≥18 years old at time of treatment 2. Diagnosis of cervical deformity- must meet one or more of the following criteria: * C2-C7 sagittal kyphosis (Cobb > 15o) * T1S-CL > 35o * Segmental cervical kyphosis > 10o between any 2 vertebra between C2-T1 or > 15o across any 3 vertebra between C2-T1 * Cervical scoliosis > 10o (Cobb angle must include end vertebra within the cervical spine) * C2-C7 SVA > 4cm * McGregor's slope > 20 degrees or CBVA > 25 degrees 3. Plan for surgical correction of cervical deformity in the next 6 months
Receives: Procedure: Surgical intervention

What is being measured

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

  1. Pain Numeric rating scale (NRS) - Headaches

    Self-reported pain in Head where 0=no pain/10=severe pain

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  2. Pain Numeric rating scale (NRS) - Neck

    Self-reported pain in Neck where 0=no pain/10=severe pain

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  3. Pain Numeric rating scale (NRS) - Upper extremity

    Self-reported pain in Arms where 0=no pain/10=severe pain

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  4. Pain Numeric rating scale (NRS) - Lower extremity

    Self-reported pain in Legs where 0=no pain/10=severe pain

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  5. Pain Numeric rating scale (NRS) - Back

    Self-reported pain in Back where 0=no pain/10=severe pain

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  6. Neck Disability Index (NDI)

    Patient reported neck disability tool

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  7. Veterans RAND 12 Item Health Survey (VR-12)

    Patient reported outcome

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  8. Patient-Reported Outcome Measurement Information System (PROMIS) - Anxiety

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  9. Patient-Reported Outcome Measurement Information System (PROMIS) - Depression

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  10. Patient-Reported Outcome Measurement Information System (PROMIS) - Pain Interference

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  11. Patient-Reported Outcome Measurement Information System (PROMIS) - Physical Function

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  12. Patient-Reported Outcome Measurement Information System (PROMIS) - Social Satisfaction (Role)

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  13. Patient-Reported Outcome Measurement Information System (PROMIS) - Social Satisfaction (DSA)

    Computer adaptive PROs

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  14. Spine Radiographs

    Radiographic parameters (Cervical lordosis, Kyphosis, Scoliosis; Global balance in coronal and sagittal planes of the spine; pelvic parameters (pelvic incidence, tilt, slope) and bony fusion status.

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  15. Modified Japanese Orthopaedic Association Scale (mJOA)

    Patient reported outcome measuring functional status using scale of 0 to 18. The higher the score, the less disability.

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

Secondary outcomes (6)
  1. EAT-10

    Measures swallowing difficulties as reported by the patient.

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  2. Voice Handicap Index (VHI-10)

    Measures voice handicap as reported by the patient.

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  3. Adverse evnts

    Any adverse events occurring \& meeting study established reporting criteria

    Measured: 3 months and 1, 2, 5 & 10 year post treatment

  4. Edmonton Frail Scale

    Frailty scale from 0 to 17 where the higher the score the more frail the patient

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  5. CHSF Frail Scale

    Clinical Frailty Scale from 1 to 9 where the higher the score, the more frail the patient

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

  6. Dynamometer Hand Grip Strength test

    With patient seated, patient will squeeze dynamometer as hard as he/she can with each hand.

    Measured: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up

Timeline

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

  1. First posted11 Dec 2019
  2. Study start1 Aug 2019
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Jul 2030 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04194996
Sponsor's protocol ID
2131
Acronym
PCD 2
Status last verified
Feb 2026
First submitted
25 Nov 2019
Last updated
17 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Cervical Deformity, run by International Spine Study Group Foundation at 16 sites 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 14 inclusion and 5 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: looking for participants now, as of the sponsor's last update on 17 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Christine Baldus, MS (6184444130, baldusc@wustl.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Numeric rating scale (NRS) - Headaches (time frame: Change from Preop to 3 months, 6 months and 1, 2, 5 & 10 year follow-up). The study lists 15 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 17 Feb 2026.

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