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Lumbar Spine DegenerationALAMBUNCT04914728

Mini-invasive Lumbar Arthrodesis in Ambulatory

A study testing mini-invasive lumbar arthrodesis in people with Lumbar Spine Degeneration, run by Elsan at 1 site in France.

Completed

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

Official record
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Trial summary

Degenerative lumbar pathologies are characterised by functional impairment and the occurrence of severe chronic pain and disability Arthrodesis of the lumbar spine is a common surgery for the treatment of degenerative lumbar pathologies. It is commonly performed during a hospital stay that can vary from 3 to 7 days. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Lumbar Spine Degeneration
What is being tested?
mini-invasive lumbar arthrodesis
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
39 participants
Where
1 siteFrance
Study dates
28 Sep 2020to 17 Dec 2021
Phase
Interventional
Are there results?
None posted in the registry

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 18 and 75 years
  • Patients affiliated to a social security system.
  • Informed, dated and signed consent
  • ASA 1 or 2
  • Patient compliant and adhering to protocol visits
  • Indication for a 1-level mini-invasive lumbar arthrodesis performed by anterior or posterior approach
  • Failure of conservative treatment for more than 3 months

Who cannot join

  • History of lumbar arthrodesis
  • Active neoplasia
  • History of osteoporotic fractures of the spine
  • Arthrodesis superior to 1 level
  • Intolerance or contraindication to morphine treatments
  • Respiratory insufficiency
Show all 15Show fewer
  • Preoperative anticoagulant treatment
  • Contraindication to the ambulatory care: patient living alone at home, or at a distance from the establishment, and thus requiring a follow-up care and rehabilitation hospitalization
  • Patient with a body mass index of greater than 40 kg/m².
  • Patient with a fever (>38°C)
  • Suspected or known allergy or intolerance to the materials used and requiring a combination of different metals.
  • Patient with a contraindication to the material used or for whom the use of the implant could interfere with their anatomical structures or expected physiological function.
  • Pregnant or breastfeeding women
  • Patient participating to an ongoing study that may interfere with the present study
  • Patient under legal protection

Trial locations and contacts

1 site in 1 country.

France1 site
  • Unité de Chirurgie de la Colonne Vertébrale

    Bruges, 33520

Other trials in France

About this study

Official title: Mini-invasive Lumbar Arthrodesis in Ambulatory: Pilot Study "ALAMBU"

Degenerative lumbar pathologies are characterised by functional impairment and the occurrence of severe chronic pain and disability Arthrodesis of the lumbar spine is a common surgery for the treatment of degenerative lumbar pathologies. It is commonly performed during a hospital stay that can vary from 3 to 7 days. The development of mini-invasive techniques and the development of the Improved Rehabilitation after Surgery programmes, has considerably reduced the hospital stay of the patients. It is possible that in the future mini-invasive lumbar arthrodesis will be performed on an ambulatory as a standard procedure, but its safety, efficacy and patient satisfaction must be proven and validated.

Read the detailed description

Degenerative lumbar disease (DLD) is a condition of increasing frequency, affecting millions of patients worldwide. They are characterised by functional impairment and the occurrence of severe chronic pain and disability.

Arthrodesis of the lumbar spine is a common surgery for the treatment of DLD. It is commonly performed during a hospital stay that can vary from 3 to 7 days. The advent of mini-invasive techniques and the development of Improved Rehabilitation after Surgery program has made it possible to considerably reduce the duration of hospitalization of patients with a high rate of satisfaction, a reduction in costs and without increasing morbidity. In spinal surgery, decompression procedures such as discectomy and lumbar recalibration are frequently performed on an ambulatory. The first American studies with a low level of evidence on the management of mini-invasive lumbar arthrodesis are beginning to appear. It is quite possible that in the future this type of procedure will be carried out on an ambulatory as a standard procedure, but its safety, efficacy and patient satisfaction must be proven and validated. In the United States, 23-hour hospitalizations are considered as ambulatory procedures, whereas in France, ambulatory is qualified as such when the patient is admitted and discharged in the same day.

The study population was patients who had failed medical treatment (analgesics and rehabilitation) for more than three months and who required a mono-segmental arthrodesis procedure for the management of their lumbar-radiculalgia.

Being tested
mini-invasive lumbar arthrodesis
Keywords
mini-invasive lumbar arthrodesis

What participants receive

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

  • mini-invasive lumbar arthrodesisProcedure or surgery

    • The mini-invasive posterior approach is performed using a trans-muscular Wiltse approach. Pedicle screws, neurological decompression and intersomatic cage placement are performed.
    • The mini-invasive anterior approach is performed via a left retroperitoneal pararectal approach. After complete discectomy, an intersomatic cage stabilised by a screwed plate will be placed.
Study groups in NCT04914728
Study groupRoleWhat they receive
mini-invasive lumbar arthrodesisExperimentalThe patient will be admitted to the hospital on the morning of the surgery, operated on the same morning by either the posterior or anterior mini-invasive approach. The choice of the approach depends on the specificity of the pathology leading to the arthrodesis procedure and the surgeon's experience. It is the surgeon who decides this in agreement with the patient. The patient will be discharged in the evening after agreement of the anaesthetist and the surgeon.
Receives: Procedure: mini-invasive lumbar arthrodesis

What is being measured

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

  1. To evaluate the feasibility of mini-invasive lumbar arthrodesis on an ambulatory in patients with degenerative lumbar disease who have failed with conventional treatment.

    Percentage of patients with same-day discharge

    Measured: within 24 hours after surgery

Secondary outcomes (41)
  1. Evaluate the safety of ambulatory lumbar arthrodesis

    Record of adverse event

    Measured: through study completion, an average of 1 year

  2. Evaluate early morbidity

    Occurrence of re-hospitalization and/or emergency readmission and/or need for re-operation of the patient

    Measured: within 1st week

  3. Evaluate the short-term morbidity

    Presence of a cicatrization disorder, the occurrence of an infection, neurological damage, adverse event related to the implants, vascular and/or medical problem.

    Measured: within 1st month

  4. Evaluate the mid-term morbidity

    occurrence of pseudoarthrosis

    Measured: within 1st year

  5. Evaluate the patients' quality of life

    Short Form-36 Health Survey questionnaire

    Measured: at 1-month visit

  6. Evaluate the patients' quality of life

    Evaluated by Oswestry

    Measured: at 1-month visit

  7. Evaluate the patients' quality of life

    Evaluated by Short Form-36 Health Survey questionnaire

    Measured: at 6-month visit

  8. Evaluate the patients' quality of life

    Evaluated by Oswestry

    Measured: at 6-month visit

  9. Evaluate the patients' quality of life

    Evaluated by Short Form-36 Health Survey questionnaire

    Measured: at 1-year visit

  10. Evaluate the patients' quality of life

    Evaluated by Oswestry

    Measured: at 1-year visit

  11. Evaluate the patients' quality of life

    Return to professional activity

    Measured: at 1-month visit

  12. Evaluate the patients' quality of life

    Return to professional activity

    Measured: at 6-month visit

  13. Evaluate the patients' quality of life

    Return to professional activity

    Measured: at 1-year visit

  14. Evaluate radiological parameters

    The radiological parameter: L1S1 lumbar lordosis

    Measured: at 1-month visit

  15. Evaluate radiological parameters

    The radiological parameter: Segmental lordosis of the arthrodesis level

    Measured: at 1-month visit

  16. Evaluate radiological parameters

    The radiological parameter: Pelvic Incidence

    Measured: at 1-month visit

  17. Evaluate radiological parameters

    The radiological parameter: Pelvic version

    Measured: at 1-month visit

  18. Evaluate radiological parameters

    The radiological parameter: Sacral slope

    Measured: at 1-month visit

  19. Evaluate radiological parameters

    The radiological parameter: Disc height

    Measured: at 1-month visit

  20. Evaluate radiological parameters

    The radiological parameter: L1S1 lumbar lordosis

    Measured: at 6-month visit

  21. Evaluate radiological parameters

    The radiological parameter: Segmental lordosis of the arthrodesis level

    Measured: at 6-month visit

  22. Evaluate radiological parameters

    The radiological parameter: Pelvic Incidence

    Measured: at 6-month visit

  23. Evaluate radiological parameters

    The radiological parameter: Pelvic version

    Measured: at 6-month visit

  24. Evaluate radiological parameters

    The radiological parameter: Sacral slope

    Measured: at 6-month visit

  25. Evaluate radiological parameters

    The radiological parameter: Disc height

    Measured: at 6-month visit

  26. Evaluate radiological parameters

    The radiological parameter: L1S1 lumbar lordosis

    Measured: at 1-year visit

  27. Evaluate radiological parameters

    The radiological parameter: Segmental lordosis of the arthrodesis level

    Measured: at 1-year visit

  28. Evaluate radiological parameters

    The radiological parameter: Pelvic Incidence

    Measured: at 1-year visit

  29. Evaluate radiological parameters

    The radiological parameter: Pelvic version

    Measured: at 1-year visit

  30. Evaluate radiological parameters

    The radiological parameter: Sacral slope

    Measured: at 1-year visit

  31. Evaluate radiological parameters

    The radiological parameter: Disc height

    Measured: at 1-year visit

  32. Evaluate patient satisfaction with the procedure

    Satisfaction score

    Measured: at 1-month visit

  33. Evaluate patient satisfaction with the procedure

    Satisfaction score

    Measured: at 6-month visit

  34. Evaluate patient satisfaction with the procedure

    Satisfaction score

    Measured: at 1-year visit

  35. Evaluate lumbar pain

    Lumbar Visual Analogue Scales pain

    Measured: at 1-month visit

  36. Evaluate lumbar pain

    Lumbar Visual Analogue Scales pain

    Measured: at 6-month visit

  37. Evaluate lumbar pain

    Lumbar Visual Analogue Scales pain

    Measured: at 1-year visit

  38. Evaluate radicular pain

    Radicular Visual Analogue Scales pain

    Measured: at 1-month visit

  39. Evaluate radicular pain

    Radicular Visual Analogue Scales pain

    Measured: at 6-month visit

  40. Evaluate radicular pain

    Radicular Visual Analogue Scales pain

    Measured: at 1-year visit

  41. Evaluate lumbar and radicular pain

    record of analgesic treatments taken before and after surgery

    Measured: before the 1-month visit

Timeline

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

  1. First posted7 Jun 2021
  2. Study start28 Sep 2020
  3. Primary completion17 Dec 2021
  4. Study completion17 Dec 2021

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 N/A
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Model description
Single-centre, pilot study evaluating the feasibility, difficulties and morbidity of ambulatory lumbar arthrodesis
Masking
None (open label)
Enrolment
39 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04914728
Sponsor's protocol ID
ALAMBU
Other IDs
2020-A01211-38
Acronym
ALAMBU
Status last verified
Nov 2022
First submitted
17 May 2021
Last updated
21 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002.

    PubMed 21665125
  • Peng CW, Yue WM, Poh SY, Yeo W, Tan SB. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976). 2009 Jun 1;34(13):1385-9. doi: 10.1097/BRS.0b013e3181a4e3be.

    PubMed 19478658
  • Dietz N, Sharma M, Adams S, Alhourani A, Ugiliweneza B, Wang D, Nuno M, Drazin D, Boakye M. Enhanced Recovery After Surgery (ERAS) for Spine Surgery: A Systematic Review. World Neurosurg. 2019 Oct;130:415-426. doi: 10.1016/j.wneu.2019.06.181. Epub 2019 Jul 2.

    PubMed 31276851
  • Sivaganesan A, Hirsch B, Phillips FM, McGirt MJ. Spine Surgery in the Ambulatory Surgery Center Setting: Value-Based Advancement or Safety Liability? Neurosurgery. 2018 Aug 1;83(2):159-165. doi: 10.1093/neuros/nyy057.

    PubMed 29538716
  • Wiltse LL, Bateman JG, Hutchinson RH, Nelson WE. The paraspinal sacrospinalis-splitting approach to the lumbar spine. J Bone Joint Surg Am. 1968 Jul;50(5):919-26. No abstract available.

    PubMed 5676831
  • Harmon PH. A simplified surgical technic for anterior lumbar diskectomy and fusion; avoidance of complications; anatomy of the retroperitoneal veins. Clin Orthop Relat Res. 1964 Nov-Dec;37:130-44. No abstract available.

    PubMed 5889125
  • Perneger TV, Leplege A, Etter JF, Rougemont A. Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. J Clin Epidemiol. 1995 Aug;48(8):1051-60. doi: 10.1016/0895-4356(94)00227-h.

    PubMed 7775992
  • Hayashi K, Boissiere L, Guevara-Villazon F, Larrieu D, Nunez-Pereira S, Bourghli A, Gille O, Vital JM, Pellise F, Sanchez Perez-Grueso FJ, Kleinstuck F, Acaroglu E, Alanay A, Obeid I. Factors influencing patient satisfaction after adult scoliosis and spinal deformity surgery. J Neurosurg Spine. 2019 May 10;31(3):408-417. doi: 10.3171/2019.2.SPINE181486. Print 2019 Sep 1.

    PubMed 31075761
  • Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res. 2016 Jun;25(3):1057-73. doi: 10.1177/0962280215588241. Epub 2015 Jun 19.

    PubMed 26092476

Questions about this trial

What is this clinical trial studying?

A study testing mini-invasive lumbar arthrodesis in people with Lumbar Spine Degeneration, run by Elsan at 1 site in France.

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 7 inclusion and 15 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 21 Nov 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 France. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

To evaluate the feasibility of mini-invasive lumbar arthrodesis on an ambulatory in patients with degenerative lumbar disease who have failed with conventional treatment. (time frame: within 24 hours after surgery). 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 NCT04914728, which also lists 9 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 21 Nov 2022.

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