NCT05013203

Brief Summary

During revision spinal surgery for aseptic indications, there remains a concern that the failure may have resulted from undetectable subclinical infection. In the common revision indications of hardware loosening and adjacent segment disease it is possible that bacterial colonization and low-grade infection precipitated the failure event. There is also significant controversy on the role infectious processes have in the development of degenerative disc disease (modic changes). In particular, this study will investigate whether discogenic colonization with Propionibacterium acnes (P. acnes) can be associated with modic changes. Whereas, in surgery for known spinal infection, epidural abscess and septic revisions, it is possible that standard culture techniques fail to detect polymicrobial flora or accurate speciation. This may lead to inappropriate antibiotic management that is not addressing the range of pathology present. There remains an incomplete understanding of the role that subclinical infection plays in aseptic spinal revision surgery and degenerative disc disease

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
450

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Feb 2021

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 18, 2021

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

August 13, 2021

Completed
6 days until next milestone

First Posted

Study publicly available on registry

August 19, 2021

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 28, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 28, 2022

Completed
Last Updated

August 19, 2021

Status Verified

August 1, 2021

Enrollment Period

1 year

First QC Date

August 13, 2021

Last Update Submit

August 13, 2021

Conditions

Outcome Measures

Primary Outcomes (3)

  • Postoperative complications

    complications that patients experience after surgery will be noted from the patient chart after they have been evaluated by their surgeon

    1 year

  • Patient Satisfaction

    will be measured using the Short Form 12 Physical and Mental Score (SF-12)

    1 year

  • Patient pain

    will be measured using the Visual Analog Scale Neck and Arm Pain Score (VAS)

    1 year

Study Arms (3)

Aseptic (uninfected) Revision Spine Surgery

Aseptic revision for indications including but not limited to hardware failure, adjacent segment pathology, radiculopathy, instability, cord compression.

Diagnostic Test: Tissue cultureDiagnostic Test: Next Generation Sequencing

Spine Surgery for Degenerative Disease

Primary degenerative pathology surgery where a disc sample is extracted to enable spinal decompression or fusion. The potential primary surgeries include but are not limited to microdiscectomy, laminectomy, and lumbar and cervical fusion

Diagnostic Test: Tissue cultureDiagnostic Test: Next Generation Sequencing

Septic (infected) Revision Spine Surgery

Spine surgery for known infection specifically: epidural abscess or septic revision. Epidural abscess must be managed surgically for inclusion. Septic revision cases include any surgery to address infected hardware from a previous spinal surgery.

Diagnostic Test: Tissue cultureDiagnostic Test: Next Generation Sequencing

Interventions

Tissue cultureDIAGNOSTIC_TEST

Discarded tissue collected during surgery will be sent to the hospital microbiological lab for aerobic and anaerobic

Aseptic (uninfected) Revision Spine SurgerySeptic (infected) Revision Spine SurgerySpine Surgery for Degenerative Disease

Discarded tissue collected during surgery will be sent to an outside lab for testing using next generation sequencing (NGS)

Aseptic (uninfected) Revision Spine SurgerySeptic (infected) Revision Spine SurgerySpine Surgery for Degenerative Disease

Eligibility Criteria

Age18 Years+
Sexall
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients who are having spine surgery who are \>18 years old for degenerative disease, infection, and malignancy.

You may qualify if:

  • All patients \>18 years of age undergoing spinal surgery

You may not qualify if:

  • All patients \<18 years of age undergoing spinal surgery

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Rothman Orthopaedic Institute

Philadelphia, Pennsylvania, 19107, United States

Location

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 13, 2021

First Posted

August 19, 2021

Study Start

February 18, 2021

Primary Completion

February 28, 2022

Study Completion

February 28, 2022

Last Updated

August 19, 2021

Record last verified: 2021-08

Locations