Status:

COMPLETED

The Duration of External Neck Stabilisation (DENS) Trial

Lead Sponsor:

University of Edinburgh

Conditions:

Odontoid Fracture

Eligibility:

All Genders

Phase:

NA

Brief Summary

The Duration of External Neck Stabilisation (DENS) study is a randomised controlled trial comparing early removal of a hard collar with treatment in a hard collar for 12 weeks in older or frail adults...

Detailed Description

This is a non-blinded randomised controlled trial with nested qualitative research comparing early removal of a hard collar (intervention) with treatment in a hard collar for 12 weeks (standard care) ...

Eligibility Criteria

Inclusion

  • Rockwood clinical frailty scale (CFS) of 5 or more, or aged 65 years or over;
  • A recent odontoid fracture (type I-III) (within 3 weeks) as assessed on CT, irrespective of degree of fracture angulation, displacement or canal narrowing;
  • History of recent trauma (within 3 weeks)
  • Determined by spinal consultant (or delegated registrar) as suitable for standard care 12-week treatment with hard collar and for randomisation to treatment without a collar
  • Recruited within 3 weeks of injury

Exclusion

  • New neurological deficit (numbness / weakness) attributable to fracture;
  • Assessed as unable to tolerate a hard collar e.g., dystonia, fixed deformity;
  • Additional (non-odontoid) cervical spine fracture not suitable for management without a hard collar;
  • Underlying condition potentially leading to spinal instability, e.g., ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis (DISH);
  • Fracture suspected to be older than three weeks at the time of assessment;
  • Consultant spinal surgeon determines fracture requires surgical treatment or is otherwise unsuitable for non-surgical treatment with or without a hard collar;
  • If not expected to survive to hospital discharge based on concomitant injuries or illnesses.

Key Trial Info

Start Date :

November 18 2021

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

June 10 2024

Estimated Enrollment :

138 Patients enrolled

Trial Details

Trial ID

NCT04895644

Start Date

November 18 2021

End Date

June 10 2024

Last Update

September 19 2024

Active Locations (1)

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1

Royal Infirmary of Edinburgh

Edinburgh, United Kingdom, EH16 4SA