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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03880292
Registration number
NCT03880292
Ethics application status
Date submitted
13/03/2019
Date registered
19/03/2019
Date last updated
21/11/2022
Titles & IDs
Public title
Spinal Deformity Intraoperative Monitoring.
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Scientific title
SDIM: Spinal Deformity Intraoperative Monitoring. Understanding and Managing Intraoperative Neuromonitoring Changes During Spinal Deformity Surgery: a Prospective Interventional Study
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Secondary ID [1]
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SDIM
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Spinal Deformity
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Condition category
Condition code
Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Reproductive Health and Childbirth
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Document intraoperative Maneuvers
Other: Intraoperative Maneuvers - To document intraoperative maneuvers performed in repsonse to alerts
Treatment: Surgery: Document intraoperative Maneuvers
Monitoring procedure during surgery
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of intraoperative neuromontoring alerts
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Assessment method [1]
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Number of intraoperative neuromonitoring alert, defined as a major change in neuromonitoring signals:
* SSEP: amplitude loss \> 50%
* MEP: amplitude loss \> 50% in two of three muscle groups and/or
* EMG: sustained activity for \> 10 seconds
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Timepoint [1]
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Intraoperative
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Secondary outcome [1]
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Intraoperative monitoring alert
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Assessment method [1]
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Intraoperative monitoring alerts:
• Degree of change in the monitoring signals (SSEP, MEP, EMG)
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Timepoint [1]
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Intraoperative
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Secondary outcome [2]
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Success rate of reversal maneuvers to restore signal above the threshold
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Assessment method [2]
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Number and type of maneuver(s) in response to an alert
* number and type of successful maneuvers
* number and type of unsuccessful maneuvers
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Timepoint [2]
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Intraoperative
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Secondary outcome [3]
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Neurological status
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Assessment method [3]
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Neurological status:
• ASIA Lower extremity motor and sensory score including if a spinal cord syndrome is applicable. A scale from 0 to 5 points in which 0 denotes total paralysis and 5 normal active movement. Sensory will be meassured as either normal, altered or absent.
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Timepoint [3]
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Baseline up to 30 days postoperative
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Secondary outcome [4]
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Timing of intraoperative monitoring alerts
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Assessment method [4]
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Timing: Minutes since skin incision and minutes until recovery in MEP and SSEP
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Timepoint [4]
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Intraoperative
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Eligibility
Key inclusion criteria
* Age >10 years to <80 years
* Neurologically intact spinal cord (with or without radiculopathy)
* Undergoing primary or revision procedure in the spine
* Anterior and/or posterior surgical approach for any of the following:
* Correction of spinal deformity with a major Cobb angle of = 80° in the coronal or sagittal plane
* Correction of high grade spondylolisthesis (Grades 3- 5)
* Posterior column or 3-column osteotomy
* Requiring multimodal neuromonitoring with EMG, SSEP, and MEP as per standard of care
* Informed consent obtained for patients i.e.:
* Ability to understand the content of the patient information
* Willingness and ability to participate in the clinical investigation according to the Clinical Investigation Plan (CIP)
* Signed and dated EC/IRB approved written informed consent OR
* Written consent obtained according to defined and IRB/EC approved procedures for patients who are not able to provide independent written informed consent
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Minimum age
10
Years
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Maximum age
80
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Neurodegenerative disease
* Upper motor neuron lesion
* Growing rods or growth guidance procedures
* Tether or staple procedures
* Stand-alone cervical deformity correction procedures
* Any not medically managed severe systemic disease
* Recent history of substance abuse (ie recreational drugs, alcohol) that would preclude reliable assessment
* Pregnancy or women planning to conceive within the study period
* Prisoner
* Participation in any other medical device or medicinal product study that could influence the results of the present study
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
15/05/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/11/2022
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Sample size
Target
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Accrual to date
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Final
569
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal North Shore Hospital - Saint Leonards
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Recruitment postcode(s) [1]
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2065 - Saint Leonards
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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United States of America
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State/province [2]
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Minnesota
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United States of America
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New York
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Country [4]
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United States of America
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North Carolina
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Country [5]
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United States of America
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Virginia
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Brazil
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Florianópolis
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Brazil
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São Paulo
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Canada
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Montréal
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Canada
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Toronto
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China
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Nanjing
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Hong Kong
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Hong Kong
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India
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Guntur
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India
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Kolkata
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Israel
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Tel Aviv
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Japan
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Hamamatsu
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Netherlands
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Nijmegen
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Pakistan
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Lahore
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Spain
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Barcelona
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Turkey
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Istanbul
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Country [20]
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United Kingdom
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London
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United Kingdom
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Manchester
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Country [22]
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United Kingdom
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State/province [22]
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Nottingham
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Funding & Sponsors
Primary sponsor type
Other
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Name
AO Foundation, AO Spine
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
A multicenter, international prospectively collected patient cohort undergoing high-risk spinal cord level surgery or spinal osteotomy procedures will be enrolled to establish the incidence of intraoperative alerts in high-risk spinal cord cases, and explore factors associated with mitigating injury. Baseline, intraoperative, and postoperative characteristics, including demographics, radiological features, lower extremity motor score (LEMS), procedure, anesthetic agents used, and baseline blood pressure will be recorded for either adult patients or pediatric patients.
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Trial website
https://clinicaltrials.gov/study/NCT03880292
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
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Address
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03880292
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