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NCT06368245Recruiting

Durability of Suppl. Rod Constructs-SuppleMentAry Rod Technique for Long-segment Posterior Instrumented Spinal Fusions

AO Foundation, AO Spine

Start Date

3/24/2025

Completion Date

7/31/2029

Summary

This is a multicenter retrospective comparative cohort study. The index surgery for this study is primary or revision long-segment posterior thoracolumbar (TL) instrumented fusion using either a supplementary rod construct or a dual-rod construct. Eligible patients who already had index surgery, will be identified for enrollment through a review of medical records of the participating surgeons at the study sites.

Detailed Description

This multicenter retrospective comparative cohort study will enroll 1244 patients, who underwent primary or revision long-segment posterior thoracolumbar (TL) instrumented fusion using either a supplementary rod construct or a dual-rod construct. By comparing two groups of patients, ie, patients treated with supplementary rod constructs vs dual-rod constructs, in the setting of long-segment posterior instrumented spinal fusion, this study aims to provide quality evidence regarding the benefits of supplementary rod constructs in reducing the risk of RFs and other mechanical complications. This study shall provide the first long-term clinical evidence on clinical outcome and benefit of supplementary rod constructs. All participating surgeons will be asked to identify a time point, denoted as X, when they started using predominantly either supplementary rod constructs or dual-rod constructs for long-segment posterior TL instrumented spinal fusion. This time point X must be on or before December 31, 2020 (the last eligible date for the index surgery). Participating surgeons will be instructed to select the time point X to be as early within the collection window as feasible to maximize the available FU period. Once the time point X is identified for a participating surgeon, medical records of patients treated by this surgeon will be reviewed to identify consecutive eligible patients with the index surgery done between the time point X and December 31, 2020, inclusive. In the case that an eligible patient had undergone several surgeries during this period, the first primary or revision of long-segment posterior TL instrumented fusion using either a supplementary rod construct or a dual-rod construct is defined as the index surgery. Patients will then be grouped based on the rod constructs into either the supplementary rod construct group or dual-rod construct group. The study has two FU periods: * The first FU period is the first 2 years after the index surgery. The primary analysis will be done using data from the first 2 years of FU. * The second FU period ends on December March 31, 20232024. The duration of this FU therefore ranges from 3 years and 3 months to 10 years and 3 months. The primary study endpoint is the occurrence of the first RF within 2 years after the index surgery.

Eligibility Criteria

Age Range: 45 years to No maximum

Inclusion Criteria: * Age 45 years and older. * Patients receiving long-segment posterior TL instrumented fusion using either supplementary rod constructs or dual-rod constructs (the index surgery). * Long-segment is defined as the UIV at a thoracic level and the LIV at the sacrum/ilium. * Supplementary rod constructs are defined as: in addition to the traditional two primary rods, at least one supplementary rod (eg, accessory rods or satellite rods) is used, and at least one supplementary rod and one primary rod (ie, at least two rods) together must span multiple (≥ 2) vertebral levels. The supplementary rod constructs do not include rods connected end-to-end or side-to-side that do not bridge multiple vertebral levels. * The index surgery can be a primary surgery or a revision surgery. * The index surgery, staged or non-staged, must use posterior spinal fusion but can be in combination with other approaches such as an anterior procedure. * If the index surgery is a revision surgery, the primary rods must be replaced in the revision surgery, with the exception of Harrington or Luque rods which can remain in place. o If the Harrington or Luque rods remain in situ, they must already have the UIV at the thoracic level and the LIV at the sacrum/ilium, or an extension of the existing Harrington or Luque is performed such that the UIV is at the thoracic level and the LIV at the sacrum/ilium. * The index surgery was performed between January 1, 2014, and December 31, 2020, inclusive. * Minimum 3 months of FU after the index surgery. * Ability to provide informed consent according to the IRB/EC defined and approved procedures if applicable for retrospective data analysis. Exclusion Criteria: * Spinal fusion performed for acute trauma (ie, ≤ 1 year of trauma). * Spinal fusion performed for tumor. * Spinal fusion performed for infection. * Patients with Parkinson's Disease. * Patients with neuromuscular disorders. * Patients with spine malignancies requiring chemo- or radiation therapy.

Interventions

PROCEDURE

long-segment posterior TL instrumented fusion

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Conditions

Spinal Fusion

Locations

Stanford Spine Clinic

Redwood City, California 94588

United States

University of California

Sacramento, California 95819

United States

UCSF Spine Center

San Francisco, California 94144

United States

John Hopkis Hospital

Baltimore, Maryland 21287

United States

University of Minnesota Medical Center

Minneapolis, Minnesota 55454

United States

Washington University in St. Louis, School of Medicine

St Louis, Missouri 63110

United States

Washington University in St. Louis, School of Medicine, Saint Louis, Missouri 63110

St Louis, Missouri 63310

United States

Columbia University / NYP Och Spine Hospital

New York, New York 10032

United States

University of Virginia

Charlottesville, Virginia 22908

United States

University of Calgary Spine

Calgary, T2N 2T9

Canada

University of Toronto

Toronto, M5T 2S8

Canada

Duchess of Kent Children's Hospital

Hong Kong,

China

Kothari Medical Centre

Kolkata,

India

Hamamatsu University School of Medicine

Hamamatsu, 431-3192

Japan

University of Tokyo

Tokyo, 113-8654

Japan

Hospital Vall d´Hebron

Barcelona, 08035

Spain

Acibadem Maslak Hospital

Istanbul,

Turkey (Türkiye)