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Study to Investigate the Performance of Cervical Arthroplasty for the Treatment of Cervical Degenerative Disc Disease

A Multi-Centre, Prospective, Randomized, Post Marketing Surveillance Study Comparing Cervical Arthroplasty to Anterior Cervical Discectomy and Fusion (ACDF) for the Treatment of Cervical Degenerative Disc Disease

Status
Terminated
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00700739
Enrollment
60
Registered
2008-06-19
Start date
2008-05-31
Completion date
2010-05-31
Last updated
2015-09-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cervical Degenerative Disc Disease

Keywords

Cervical, Disc, Arthroplasty, Spinal

Brief summary

The purpose of the study is to evaluate the performance of the Discover cervical Artificial disc in the treatment of degenerative disc disease in one level of the cervical spine.

Detailed description

The protocol underwent 3 amendments, the last of which (02APR2009) changed the study design from a randomized to a non-randomized and non-comparative clinical trial. All of the subjects were enrolled under the randomized design with the exception of the last subject. This study is not applicable per FDAA Title VIII, Section 801 due to the final trial design. However, results are submitted to clinicaltrials.gov due to the majority of study data being collected under a randomized (FDAA Title VIII, Section 801 applicable) trial design

Interventions

DEVICEDISCOVER™ Artificial Cervical Disc

DISCOVER™ Artificial Cervical Disc

DEVICEACDF

Cervical CFRP I/F CAGE® and SLIM LOC(R) Anterior Cervical Plate System with allograft

Sponsors

DePuy International
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Male or female subjects, aged between 18 and 65 years inclusive. * Subjects who are able to give voluntary, written informed consent to participate in this clinical investigation and from whom consent has been obtained. * Subjects who, in the opinion of the Clinical Investigator, are able to understand this clinical investigation, co-operate with the investigational procedures and are willing to return to the hospital for all the required post-operative follow-ups. * Objective evidence of cervical disc disease in one vertebral level between C3-C7 defined as one or more of the following: * Shoulder and/or arm pain in a radicular distribution resulting from herniated disc or bony osteophytes (Consistent w diagnostic imaging including Axial CT, CT Myelogram, MRI and/or plain films) * Subjects with myeloradiculopathy resulting from mild spinal cord compression and nerve root impingement * Unresponsive to documented non-surgical management for ≥ 6 weeks and/or presents with progressive symptoms of nerve root or spinal cord compression in the face of continued non-surgical management (e.g., physical therapy, medication therapy, corticosteroid injections, etc.) * Minimum Neck Disability Index score of ≥30 % (15/50 points)

Exclusion criteria

* Subjects who, in the opinion of the Clinical Investigator, have an existing condition that would compromise their participation and follow-up in this clinical investigation. * Subjects who are pregnant, lactating or wishes to become pregnant within the duration of the study. * Subjects who are known drug or alcohol abusers or with psychological disorders that could affect follow-up care or treatment outcomes. * Subjects who have participated in a clinical investigation with an investigational product in the last 30 days. * Subjects who are currently involved in any injury litigation claims. * Subjects with significant degeneration at more than one cervical level (e.g. DISH, ankylosing spondylitis, congenital abnormality, rheumatoid arthritis) * Subjects who have had any prior surgery at the level to be treated (subjects with a prior Laminotomy at the level to be treated may be included in the study) * Subjects who have marked cervical instability on lateral or flexion/extension x-rays defined as translation ≥3mm and/or ≥11 degrees of rotational difference to either adjacent level * Subjects who have presence of systemic infection or infection at the site of surgery * Subjects who have been diagnosed with malignancy * Subjects who have been diagnosed with a condition or require postoperative medication(s) that may interfere with bony/soft tissue healing * Subjects who have been diagnosed with Osteoporosis, Osteopenia, other metabolic bone disease or endocrine disorder known to affect osteogenesis. * Subjects with pre-existing neurological abnormalities other than deficits produced from the spinal lesion (e.g., MS, Parkinson's, CVA, diabetic neuropathy, peripheral neuropathy). * Subjects with morbid obesity defined as a BMI of ≥40, or more than 100 lbs (45.4kg) over ideal weight. * Subjects with any known allergy to titanium metal, polyethylene, metal alloy or carbon fibre reinforced polymer * Subjects who have had prior fusion surgery at any level(s) (C1-T1) * Subjects with kyphosis \>-15 degrees evaluated using the Cobb angle measurement * Subjects with Significant cervical degenerative disease characterized by bridging anterior osteophytes, significant loss of disc space height (3mm or less), sclerotic facets, large posterior osteophytes, autofusion of other cervical levels, and degenerative retrolisthesis. Spinal diseases such as DISH, ankylosing spondylitis, congenital abnormality, and rheumatoid arthritis, should also be excluded * Subjects undergoing treatment with a bone growth stimulator, which cannot be discontinued prior to enrollment in the study. * Significant kyphotic deformity or significant reversal of lordosis.

Design outcomes

Primary

MeasureTime frameDescription
Overall Patient Success12 monthsOverall success was a composite endpoint determined by the following clinical outcome measures: 1. Neck Disability Index ≥ 15-point improvement from baseline to 12 months post-operative, 2. No new clinically significant permanent abnormalities in neurological function (i.e. motor strength, nerve root tension signs, sensory and reflex signs) from baseline to 12 months post-operative, 3. No subsequent secondary surgical interventions (SSI) at the index level, and 4. No device-related serious events (dSAE) from intra-operative through 12-months post-operative. Please note that these time periods were intended to be from baseline to 24 months post-operative, but since the study was terminated early the 12 month time periods were utilized.

Secondary

MeasureTime frameDescription
Change in Visual Analogue Scale (VAS) Left Arm Pain From Pre-treatment to 12 Months.12 MonthsThe visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their left arm.
Change in Visual Analogue Scale (VAS) Right Arm Pain From Pre-treatment to 12 Months.12 MonthsThe visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0= 0 cm) listed on the left and 'Very severe pain' (score of 100= 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their right arm.
Change in Visual Analogue Scale (VAS) Right Shoulder Pain From Pre-treatment to 12 Months.12 MonthsThe visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their right shoulder.
Change in Visual Analogue Scale (VAS) Left Shoulder Pain From Pre-treatment to 12 Months.12 MonthsThe visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 10 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their left shoulder.
Change in Mental Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months12 monthsThe 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into 2 summary measures that are scored from 0 to 100 (where 100 indicates the highest level of health) - the Physical Component Score (PCS-36) and Mental Component Score (MCS-36)
Change in Function Assessed by Neck Disability Index Improvement From Pre-treatment to 12 Months12 monthsThe neck disability index (NDI) is a validated, disease specific, self-administrated questionnaire for assessing pain intensity and function in patients with neck pain on a scale from 0 to 100. A lower score is a better result (i.e. less severe pain and/or better function). The proportion of patients with an improved score (lower) of 15 points or more was the analysis variable.
Change in Physical Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months12 monthsThe 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into 2 summary measures that are scored from 0 to 100 (where 100 indicates the highest level of health) - the Physical Component Score (PCS-36) and Mental Component Score (MCS-36)
Change in Visual Analogue Scale (VAS) Neck Pain From Pre-treatment to 12 Months12 monthsThe visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their neck.
Sagittal Angulation, Also Known as Global Lordosis, Measured Radiographically at 6 Months6 monthsSagittal Angulation is a measure of the angle formed between the inferior endplate of the C2 vertebrae and the corresponding inferior endplate of vertebrae C7 of the spine, measured in degrees, from a side (sagittal) view.
Adjacent Level Degeneration Measured Radiographically at 24 Months24 monthsAdjacent Level Degeneration is evaluated using a point system that assigns numerical scores to severity of Height Loss, Anterior Osteophytes, and Endplate Sclerosis; and then grades into one of the following five categories: None, Mild, Moderate, Severe, or NA.
Maintenance of Disc Height Measured Radiographically at 6 Months6 monthsMaintenance of disc height is measured at the index and adjacent levels to determine the effect of the treatment on restoration or maintenance of the disc height. Initial post-operative disc height is compared with subsequent post-operative visits (i.e. 6 months) to evaluate the maintenance of disc height. The height is measured in millimeters (mm).
Foraminal Height Measured Radiographically at 24 Months24 monthsForaminal height is the maximum vertical distance, measured in millimeters (mm), between the inferior surface of the superior pedicle and superior surface of the inferior pedicle. These measurements are obtained via magnetic resonance imaging (MRI).
Cervical Range of Motion Measured Radiographically at 6 Months6 monthsCervical range of motion measures the angle, in degrees, between the inferior endplate of C2 to the inferior endplate of C7 on flexion-extension radiographs.
Device Related Adverse EventsIntra-operatively to 24 months post-operativeThe proportion of subjects with device related adverse events as reported throughout the duration of the study.
Work Status Assessed at 12 Months12 monthsThe proportion of subjects with unrestricted work status (compared to subjects not working or with restricted work status) is reported at the 12 month follow-up interval.

Countries

Australia, Germany, Italy, Malaysia, Netherlands, Spain, United Kingdom

Participant flow

Recruitment details

5 sites enrolled 60 subjects who were randomized into two treatment groups. Site 12 (17 subjects total) transferred into the Discover IDE study. Site 04 (5 subjects total) did not submit data, which was limited, due to EDC technical difficulties at the site. Therefore 38 subjects are reported in this study.

Participants by arm

ArmCount
Cervical Total Disc Replacement
DISCOVER™ Artificial Cervical Disc
22
ACDF
Anterior Cervical Discectomy and Fusion (ACDF)
16
Total38

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up44

Baseline characteristics

CharacteristicCervical Total Disc ReplacementACDFTotal
Age, Continuous45.3 years
STANDARD_DEVIATION 8.87
47.5 years
STANDARD_DEVIATION 8.17
46.2 years
STANDARD_DEVIATION 8.65
Region of Enrollment
Germany
0 participants1 participants1 participants
Region of Enrollment
Spain
2 participants1 participants3 participants
Region of Enrollment
United Kingdom
20 participants14 participants34 participants
Sex: Female, Male
Female
11 Participants11 Participants22 Participants
Sex: Female, Male
Male
11 Participants5 Participants16 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
9 / 226 / 16
serious
Total, serious adverse events
3 / 221 / 16

Outcome results

Primary

Overall Patient Success

Overall success was a composite endpoint determined by the following clinical outcome measures: 1. Neck Disability Index ≥ 15-point improvement from baseline to 12 months post-operative, 2. No new clinically significant permanent abnormalities in neurological function (i.e. motor strength, nerve root tension signs, sensory and reflex signs) from baseline to 12 months post-operative, 3. No subsequent secondary surgical interventions (SSI) at the index level, and 4. No device-related serious events (dSAE) from intra-operative through 12-months post-operative. Please note that these time periods were intended to be from baseline to 24 months post-operative, but since the study was terminated early the 12 month time periods were utilized.

Time frame: 12 months

Population: Overall Patient Success is composed of several outcome measures, some of which require a valid pre-operative and 12-month post-operative score. Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for the Overall Patient Success calculation.

ArmMeasureValue (NUMBER)
Cervical Total Disc ReplacementOverall Patient Success33.33 Percentage of subjects
ACDFOverall Patient Success90.91 Percentage of subjects
Secondary

Adjacent Level Degeneration Measured Radiographically at 24 Months

Adjacent Level Degeneration is evaluated using a point system that assigns numerical scores to severity of Height Loss, Anterior Osteophytes, and Endplate Sclerosis; and then grades into one of the following five categories: None, Mild, Moderate, Severe, or NA.

Time frame: 24 months

Population: Study was terminated prior to 24 months therefore there are no results for this endpoint.

Secondary

Cervical Range of Motion Measured Radiographically at 6 Months

Cervical range of motion measures the angle, in degrees, between the inferior endplate of C2 to the inferior endplate of C7 on flexion-extension radiographs.

Time frame: 6 months

Population: Only 2 subjects in the cTDR and 2 subjects in the ACDF treatment groups were available for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementCervical Range of Motion Measured Radiographically at 6 Months53.9 degreesStandard Deviation 16.4
ACDFCervical Range of Motion Measured Radiographically at 6 Months55.2 degreesStandard Deviation 25.5
Secondary

Change in Function Assessed by Neck Disability Index Improvement From Pre-treatment to 12 Months

The neck disability index (NDI) is a validated, disease specific, self-administrated questionnaire for assessing pain intensity and function in patients with neck pain on a scale from 0 to 100. A lower score is a better result (i.e. less severe pain and/or better function). The proportion of patients with an improved score (lower) of 15 points or more was the analysis variable.

Time frame: 12 months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (NUMBER)
Cervical Total Disc ReplacementChange in Function Assessed by Neck Disability Index Improvement From Pre-treatment to 12 Months33.33 Percentage of Subjects
ACDFChange in Function Assessed by Neck Disability Index Improvement From Pre-treatment to 12 Months90.91 Percentage of Subjects
Secondary

Change in Mental Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months

The 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into 2 summary measures that are scored from 0 to 100 (where 100 indicates the highest level of health) - the Physical Component Score (PCS-36) and Mental Component Score (MCS-36)

Time frame: 12 months

Population: Due to withdrawals and incomplete or unavailable assessments, 16 subjects in the CTDR and 10 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Mental Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months4.1 units on a scaleStandard Deviation 13.2
ACDFChange in Mental Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months15.1 units on a scaleStandard Deviation 14
Secondary

Change in Physical Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months

The 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into 2 summary measures that are scored from 0 to 100 (where 100 indicates the highest level of health) - the Physical Component Score (PCS-36) and Mental Component Score (MCS-36)

Time frame: 12 months

Population: Due to withdrawals and incomplete or unavailable assessments, 16 subjects in the CTDR and 10 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Physical Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months8.1 units on a scaleStandard Deviation 11.7
ACDFChange in Physical Component Summary Quality of Life Measure Assessed by Short Form SF-36 From Pre-treatment to 12 Months17.7 units on a scaleStandard Deviation 9.2
Secondary

Change in Visual Analogue Scale (VAS) Left Arm Pain From Pre-treatment to 12 Months.

The visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their left arm.

Time frame: 12 Months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Visual Analogue Scale (VAS) Left Arm Pain From Pre-treatment to 12 Months.-15.9 units on a scaleStandard Deviation 25.7
ACDFChange in Visual Analogue Scale (VAS) Left Arm Pain From Pre-treatment to 12 Months.-46.6 units on a scaleStandard Deviation 43.5
Secondary

Change in Visual Analogue Scale (VAS) Left Shoulder Pain From Pre-treatment to 12 Months.

The visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 10 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their left shoulder.

Time frame: 12 Months

Population: Due to withdrawals and incomplete or unavailable assessments, 17 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Visual Analogue Scale (VAS) Left Shoulder Pain From Pre-treatment to 12 Months.-17.1 units on a scaleStandard Deviation 28.9
ACDFChange in Visual Analogue Scale (VAS) Left Shoulder Pain From Pre-treatment to 12 Months.-49.8 units on a scaleStandard Deviation 36.5
Secondary

Change in Visual Analogue Scale (VAS) Neck Pain From Pre-treatment to 12 Months

The visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their neck.

Time frame: 12 months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Visual Analogue Scale (VAS) Neck Pain From Pre-treatment to 12 Months-16.6 units on a scaleStandard Deviation 34.2
ACDFChange in Visual Analogue Scale (VAS) Neck Pain From Pre-treatment to 12 Months-52.1 units on a scaleStandard Deviation 22.86
Secondary

Change in Visual Analogue Scale (VAS) Right Arm Pain From Pre-treatment to 12 Months.

The visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0= 0 cm) listed on the left and 'Very severe pain' (score of 100= 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their right arm.

Time frame: 12 Months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Visual Analogue Scale (VAS) Right Arm Pain From Pre-treatment to 12 Months.-18.4 units on a scaleStandard Deviation 32.8
ACDFChange in Visual Analogue Scale (VAS) Right Arm Pain From Pre-treatment to 12 Months.-20.5 units on a scaleStandard Deviation 25.8
Secondary

Change in Visual Analogue Scale (VAS) Right Shoulder Pain From Pre-treatment to 12 Months.

The visual analogue scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 100 = 10 cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their right shoulder.

Time frame: 12 Months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 11 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementChange in Visual Analogue Scale (VAS) Right Shoulder Pain From Pre-treatment to 12 Months.-15.7 units on a scaleStandard Deviation 35.4
ACDFChange in Visual Analogue Scale (VAS) Right Shoulder Pain From Pre-treatment to 12 Months.-22.4 units on a scaleStandard Deviation 32.7
Secondary

Device Related Adverse Events

The proportion of subjects with device related adverse events as reported throughout the duration of the study.

Time frame: Intra-operatively to 24 months post-operative

ArmMeasureValue (NUMBER)
Cervical Total Disc ReplacementDevice Related Adverse Events13.64 Percentage of subjects
ACDFDevice Related Adverse Events0.00 Percentage of subjects
Secondary

Foraminal Height Measured Radiographically at 24 Months

Foraminal height is the maximum vertical distance, measured in millimeters (mm), between the inferior surface of the superior pedicle and superior surface of the inferior pedicle. These measurements are obtained via magnetic resonance imaging (MRI).

Time frame: 24 months

Population: The study was terminated prior to 24 months therefore there are no results for this endpoint.

Secondary

Maintenance of Disc Height Measured Radiographically at 6 Months

Maintenance of disc height is measured at the index and adjacent levels to determine the effect of the treatment on restoration or maintenance of the disc height. Initial post-operative disc height is compared with subsequent post-operative visits (i.e. 6 months) to evaluate the maintenance of disc height. The height is measured in millimeters (mm).

Time frame: 6 months

Population: Only 2 subjects in the cTDR and 1 subject in the ACDF treatment groups were available for this outcome measure. There were 2 ACDF subjects at this endpoint, however one subject was missing the flexion extension rotation radiographic view therefore could not be included in the analysis.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementMaintenance of Disc Height Measured Radiographically at 6 Months4.7 mmStandard Deviation 0.57
ACDFMaintenance of Disc Height Measured Radiographically at 6 Months5.1 mm
Secondary

Sagittal Angulation, Also Known as Global Lordosis, Measured Radiographically at 6 Months

Sagittal Angulation is a measure of the angle formed between the inferior endplate of the C2 vertebrae and the corresponding inferior endplate of vertebrae C7 of the spine, measured in degrees, from a side (sagittal) view.

Time frame: 6 months

Population: Only 2 subjects in the Cervical Total Disc Replacement (cTDR) and 1 subject in the ACDF treatment groups were available for this outcome measure. There were 2 ACDF subjects at this endpoint, however one subject was missing the flexion extension rotation radiographic view therefore could not be included in the analysis.

ArmMeasureValue (MEAN)Dispersion
Cervical Total Disc ReplacementSagittal Angulation, Also Known as Global Lordosis, Measured Radiographically at 6 Months9.6 degreesStandard Deviation 10
ACDFSagittal Angulation, Also Known as Global Lordosis, Measured Radiographically at 6 Months-1.5 degrees
Secondary

Work Status Assessed at 12 Months

The proportion of subjects with unrestricted work status (compared to subjects not working or with restricted work status) is reported at the 12 month follow-up interval.

Time frame: 12 months

Population: Due to withdrawals and incomplete or unavailable assessments, 18 subjects in the CTDR and 12 subjects in the ACDF treatment groups were available for this outcome.

ArmMeasureValue (NUMBER)
Cervical Total Disc ReplacementWork Status Assessed at 12 Months38.89 Percentage of Subjects
ACDFWork Status Assessed at 12 Months50.00 Percentage of Subjects

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026