Postoperative Scar in the Control Excess of Mobility Induced by Annulus Removal on Inserting a Lumbar Disc Prosthesis

Launched by UNIVERSITY OF VALENCIA · Nov 19, 2020

Keywords

ClinConnect Summary

This clinical trial is looking at how certain surgical techniques during the implantation of a lumbar disc prosthesis affect movement and healing after surgery. Specifically, the study will explore the impact of removing part of a spinal structure called the annulus fibrosus, which helps control movement in the spine. Researchers want to see how this removal affects the spine's motion and whether repairing that part during surgery improves the overall results for patients.

To participate in this trial, individuals must be between 18 and 50 years old and have chronic lower back pain linked to one or two damaged discs. They should not have had prior spinal surgeries or certain other back conditions. Participants in the study will undergo the surgical procedure and will be monitored post-surgery to understand the outcomes better. It's important to note that while this study could provide valuable insights into back surgery, it is not a substitute for standard treatments, and patients will be informed about all aspects of the study before agreeing to participate.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Minimum age of 18 years and maximum of 50 years, given that above that age there is usually degenerative pathology of the lumbar joint facets, which can confuse the symptoms and make it difficult to interpret the results.
• • Pathology compatible with chronic low back pain accompanied or not by radiculopathy originating in one or a maximum of two degenerated intervertebral discs and without signs of degeneration / osteoarthritis of the lumbar joint facets.
• • The type of lumbar pain must be discogenic, that is, worsen in flexion and not in extension, and in loading, as well as having a truncal distribution with possible anterior radiation towards the English or genital region.
• • Radiological confirmation by lumbar MRI study of lumbar discopathy of one or a maximum of two lumbar levels.
• • Absence in simple radiology studies of signs of vertebral instability or listhesis of the levels to be treated.
• • Absence of response for 6 weeks to conservative, non-surgical treatment, or presence of progressive symptoms. The treatment would also be carried out despite the absence of this study and the existence of the study does not condition in any way the treatment of the patients
• • Not having undergone any prior treatment of the type of microdiscectomy, laminectomy or lumbar arthrodesis, although these have been carried out at different levels than those involved on this occasion
• • Ability of the patient to comply with the proposed monitoring program
• • Patient's ability to follow the postoperative care program
• • Granting of informed consent
• Exclusion Criteria:
• • Signs of arthropathy of the lumbar joint facets, osteoporosis, previous interventions on the lumbar spine
• • Deformity or instability of the lumbar spine
• • Lumbar canal stenosis
• • Previous intervention on lumbar spine
• • Previous lumbar spinal fracture
• • Mobile spondylolisthesis\> 2 mm in translation and / or more than 11 ° angular difference with respect to the adjacent level on neutral vertical or flexion-extension radiographs
• • Severe osteoporosis
• • Spinal metastasis
• • Metabolic bone disease that could interfere with the implant or the surgical procedure
• • Rheumatoid arthritis, lupus, or other autoimmune disease that affects the musculoskeletal system
• • Other conditions or anatomical alterations that make the treatment of the anterior approach to the lumbar spine unfeasible
• • Known allergy to stainless steel, titanium or their alloys
• • Fixed or permanent neurological deficit
• • Active systemic infection at any time or ongoing preventive treatment for it, infection in the surgical site, HIV or hepatitis C
• • Abusive drug or alcohol use
• • Uncontrolled seizure disorder
• • Psychiatric illness that could interfere with your participation in the study
• • Participation in a current research study or in the 3 months prior to surgery
• • History of malignancy or current malignancy (except non-melanoma skin cancer), unless the patient has been treated for curative purposes and no clinical signs or symptoms have been observed for at least 5 years
• • Obesity (Body Mass Index or BMI\> 35)