Clinical Outcome and Fusion Results Using the VerteLoc® Facet Fixation Device

Spinal Stenosis

The purpose of this clinical study is to evaluate fusion of the facet joints in a prospective cohort of patients utilizing the VerteLoc facet fixation device in patients receiving lumbar laminectomy (L1-S1), without ancillary stabilization devices such as pedicle and transfacet screws.

Study Design: Non-randomized, prospective, single arm clinical trial Patient Population and Sample Size: Patients (n=25) from up to 2 clinical site, who have been medically evaluated, found appropriate for, and have agreed to treatment by lumbar decompressive laminectomy and facet fixation, including unilateral and/or bilateral posterolateral fusion according to accepted medical standards. Objectives: The primary objective of this study is to: 1. Evaluate the fusion status of facet joints following laminectomy and facet fixation using the VerteLoc system in combination with unilateral and/or bilateral posterolateral fusion. 2. Subject success / Clinical outcome: Evaluate the reduction in baseline VAS back pain score at 2-3 weeks, 3 months, and 12 months. The secondary objectives of this study are to: 1. Explore the effect of preoperative bone density on facet fusion status; 2. Assess the ease of use of the VerteLoc system; 3. Record operative time using the VerteLoc system; 4. Monitor the occurrence of adverse events related or possibly related to the use of the VerteLoc system; 5. Monitor the occurrence of subsequent surgical intervention at the target level(s). 6. Subject success/Clinical outcome (Assess additional improvement criteria) 7. Evaluate Fusion rate in relations to DEXA value Inclusion Criteria: Candidates must meet ALL of the following: 1. Have provided consent for research by signing the Institutional Review Board approved Informed Consent; 2. Have given appropriate operative consent for a decompressive lumbar (L1-S1) laminectomy procedure as standard of care; 3. Are skeletally mature, and are at least 18 years of age; 4. If female, are not pregnant; 5. Agree to adhere to post-surgical medically prescribed activity limitations and/or physical rehabilitation. Exclusion Criteria: 1. Previous surgery at the target or adjacent vertebral levels; 2. More than two intervertebral levels to be treated by the laminectomy procedure; 3. Found to be inappropriate candidates for facet fixation using the VerteLoc system; 4. Require additional and/or other surgical technique and/or approach to the laminectomy at the index level(s), which may in the opinion of the Primary Investigator confound measurement of outcome variables; 5. Has a medical disorder or is receiving medications that would be expected to interfere with osteogeneses, 6. Active malignancy or patient with a history of any malignancy (except non-melanoma skin cancer) with recurrence within 5 years of surgery; 7. Active local or systemic infection or history of local or systemic infection, immune-deficiency, uncontrolled medical conditions, which in the opinion of the Investigator may increase patient risk or confound fusion results; 8. BMI \>40% ; 9. History of tobacco smoking within the past 6 months; 10. Has a history of alcoholism, medication or drug abuse, psychosis, is a prisoner, and/or has a personality disorder, poor motivation, emotional or intellectual issues that would likely make the patient unreliable for participation in the study; 11. Are participating in any other clinical trial. Study Duration : 12 months Study Outcomes: The primary study outcomes of this study are: 1. Fusion grade at 12 month follow-up using CT scans with a grading system based on: 1. Complete fusion; 2. Partial fusion; 3. No fusion; 2. Subject success / Clinical outcome: Evaluate the reduction in baseline VAS back pain score at: 1. 2-3 weeks 2. 3 months 3. 12 months. The secondary outcomes of this study are: 1. Statistical correlation of DEXA scan bone mass density score to CT and radiographic fusion status; 2. Surgeon opinion of ease of use utilizing the VerteLoc system (0-10); 3. Operative time (minutes) from surgical access to completion of device placement 4. Occurrence and prevalence of adverse events related or possibly related to the use of the VerteLoc System; 5. Occurrence of subsequent surgical intervention at the target level(s). Study Assessments * Intraoperative: Post-placement radiograph; * 12 months: A/P and lateral flexion and extension lumbar radiograph and lumbar CT scan. Statistical Analysis • Student t-tests

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