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Home > "S" Clinical Trials Conditions > Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis  Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis
Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis
For Condition: Spondylolisthesis,Spinal Stenosis,Low Back Pain
Status: Recruiting
Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) , National Institute for Occupational Safety and Health (NIOSH/CDC),Office of Research on Women's Health (ORWH)
Synopsis: This study tests the effectiveness of different treatments for the three most commonly diagnosed conditions of the lower backbone (lumbar spine). The purpose is to learn which of two commonly prescribed treatments (surgery and nonsurgical therapy) works better for specific types of low back pain. In this part of the study, we will treat patients with spinal stenosis (a narrowing of spaces in the backbone that results in pressure on the spinal cord and/or nerve roots) caused by degenerative spondylolisthesis (a condition in which one vertebra, or spinal bone, slips forward on another) with either surgery or nonsurgical methods. This study does not cover the cost of treatment.
Details: Low back pain is considered one of the most widely experienced health problems in the U.S. and the world. It is the second most frequent condition, after the common cold, for which patients see a physician or lose days from work. Estimated costs to those who are severely disabled from low back pain range from $30-70 billion annually. Rates of spinal surgery in the U.S. have increased sharply over time, and researchers have documented 15-fold geographic variation in rates of these surgeries. In many cases, where one lives and who one sees for the condition appear to determine the rates of surgery. Despite these trends, there is little evidence proving the effectiveness of these therapies over nonsurgical management. This study will use the National Spine Network to conduct a multicenter, randomized, controlled trial for the three most common diagnostic groups for which spine surgery is performed: lumbar intervertebral disc herniation (IDH), spinal stenosis (SpS), and spinal stenosis secondary to degenerative spondylolisthesis (DS). This arm of the trial will deal with patients from the third diagnostic group. The study will compare the most commonly used standard surgical treatments to the most commonly used standard nonsurgical treatments. We will conduct the study at 12 sites throughout the United States. The primary endpoint of the study will be changes in health-related quality of life as measured by the SF-36 health status questionnaire. Secondary endpoints will include patient satisfaction with treatment, utility for current health in order to estimate quality-adjusted life years (QALYS) as the measure for cost-effectiveness, resource use, and cost. We will follow patients at 6 weeks, 3, 6, 12, and 24 months to determine their health status, function, satisfaction, and health care use. We anticipate that we will enroll and randomly allocate a total of 300 study participants in this arm of the trial. We will track an additional observational cohort to assess health and resource outcomes. Enrollment in the Observational cohort has been completed as of February 2003. We will integrate data from the trial and observational cohorts to formally estimate the cost-effectiveness of surgical versus nonsurgical interventions for IDH, SpS, and DS. The results of this trial will provide, for the first time, scientific evidence as to the relative effectiveness of surgical versus nonsurgical treatment for these three most commonly diagnosed lumbar spine conditions.
Eligibility:
Study Type: Interventional, Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Minimum Age/Maximum Age: 18 Years/
Genders: Both
Protocol Entry Criteria: Inclusion Criteria: - Duration of Symptoms: 12 or more weeks. - Treatments Tried: Nonsteroidal. anti-inflammatory medical therapy and physical therapy. - Surgical Screening: Pain in low back, buttocks, or lower extremity that becomes worse with lumbar extension. Must be confirmed by evidence of central or central-lateral compression of the cauda equina by a degenerative lesion of the facet joint, disc, or ligamentum flavum on MRI, computed tomography scans, or myelograms. - Tests: MRI to confirm diagnosis and level(s). Exclusion Criteria: - Previous lumbar spine surgery. - Not a surgical candidate for any of these reasons: Overall health that makes spinal surgery too life-threatening to be an appropriate alternative, patient has improved dramatically with conservative care, or the patient is unable (for any reason) to undergo surgery within 6 months. - Possible pregnancy. - Active malignancy: Patients with a history of any invasive malignancy (except nonmelanoma skin cancer) are ineligible unless they have been treated with curative intent AND have not had any clinical signs or symptoms of the malignancy for at least 5 years. - Current fracture, infection, and/or deformity (greater than 15 degrees of lumbar scoliosis, using Cobb measure technique) of the spine. - Age less than 18 years. - Cauda equina syndrome or progressive neurologic deficit (usually requiring urgent surgery). - Unavailability for followup (planning to move, no telephone, etc.) or inability to complete data surveys. - Symptoms less than 12 weeks. - Patient currently enrolled in any experimental "spine related" study.
Total Enrollment: 300
Location and Contact Information:
Overall Study Official:
JamesWeinstein, Principal Investigator, Dartmouth Medical School
William Beaumont Hospital *Recruiting*
Royal Oak, Michigan, 48073-9952
United States
Recruiting Gloria Bradley 248-551-7901
Nebraska Foundation for Spinal Research *Recruiting*
Omaha, Nebraska, 68154-4438
United States
Recruiting Nancy Fullmer 402-496-5513
Emory University, The Emory Clinic *Recruiting*
Decatur, Georgia, 30033
United States
Recruiting Sally Lashley 404-778-7172
Case Western Reserve University *Recruiting*
Cleveland, Ohio, 44106
United States
Recruiting Kathy Higgins (216) 844-8053
Maine Spine & Rehabilitation *Recruiting*
Scarborough, Maine, 04074
United States
Recruiting Ellen Murphy 207-885-1455
Hospital for Special Surgery *Recruiting*
New York City, New York, 10021
United States
Recruiting Brenda Sherry 212-774-2984
University of California, San Francisco (UCSF) *Recruiting*
San Francisco, California, 94143-0728
United States
Recruiting Patricia Malone 415-476-3755
Dartmouth-Hitchcock Medical Center - Spine Center *Recruiting*
Lebanon, New Hampshire, 03756
United States
Recruiting Barbara Butler-Schmidt 603-650-2590
New York University, The Hospital for Joint Diseases *Recruiting*
New York City, New York, 10003
United States
Recruiting Alex Lee 212-598-6114
Washington University *Recruiting*
St. Louis, Missouri, 63110
United States
Recruiting Georgia Stobbs 314-747-2817
Kaiser Permanente *Recruiting*
Oakland, California, 94611
United States
Recruiting Kristen Alderisio 510-752-5451
Rothman Institute at Thomas Jefferson University *Recruiting*
Philadelphia, Pennsylvania, 19107-4216
United States
Recruiting Carol Simon 267-339-3613
Rush-Presbyterian, St. Luke's Medical Center *Recruiting*
Chicago, Illinois, 60612-3833
United States
Recruiting Margaret Hickey 312-850-9179
Additional Information:
Study ID Numbers: NIAMS-004A; U01 AR45444
Study Start Date: March 2000
Record last reviewed: May 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00000409
Other Spinal Stenosis Studies:
1. Spine Patient Outcomes Research Trial (SPORT): Spinal Stenosis
2. Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis
3. Surgical versus Nonsurgical Treatment for Spinal Stenosis
Related Studies:
Other Spinal Stenosis Clinical Trials
Other New Hampshire Clinical Trials
Other Lebanon Clinical Trials
Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis
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