Actively Recruiting
Midline Versus Paramedian Approaches in Treating Degenerative Lumbar Spondylolisthesis
Led by Nova Scotia Health Authority · Updated on 2024-08-21
100
Participants Needed
1
Research Sites
413 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
For the increasing numbers of patients undergoing fusion procedures for the degenerative lumbar spine, infection and re-operation can negatively impact outcomes. Numerous observational and retrospective reviews have shown advantages to para-median versus midline approaches; however, recent systematic reviews have shown a need for a well-powered, prospective randomized control trials comparing both exposures. As a step towards a long-term goal of an RCT to address this issue, the purpose of this pilot study is to gather initial data to examine whether operative approach impacts the short-term infection rate, re-operation rate, length of stay, and overall costs to the system. Patients deemed appropriate surgical candidates with single or two-level degenerative spondylolisthesis will be approached for participation, and randomized into either the midline or paramedian group. Initial follow-ups will be at 2 and 6 weeks, and 3 months. Infection rates, inpatient and outpatient adverse events, re-operation rates, radiation exposure and costs will be determined. Cost effectiveness analysis will be estimated comparing each procedure using a bottom-up estimation. Post-operative wound infection can have a significant effect on patient short and long term outcomes. If a significant difference in infection rate is demonstrated, as well as lower re-operation rates, shorter stays, and decreased overall costs, adoption of paramedian approaches to single or two-level fusions of the lumbar spine might be suggested, providing fuel for a full-scale RCT.
CONDITIONS
Official Title
Midline Versus Paramedian Approaches in Treating Degenerative Lumbar Spondylolisthesis
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Surgical candidates with single or two-level degenerative spondylolisthesis who have:
- Back, buttock, and leg pain worsened by walking or standing and improved by lying, sitting, or bending forward
- Leg symptoms greater than or equal to back symptoms when walking or standing
- Symptoms lasting longer than 6 months despite conservative treatment
- Sufficient fluency in English to provide informed consent and complete questionnaires, with or without an interpreter
You will not qualify if you...
- History of osteoporotic fracture or chronic oral steroid use
- Previous posterior lumbar spinal surgery (excluding prior microdiscectomy)
- Evidence of neurological disorders affecting physical function (e.g., peripheral neuropathy), neuromuscular disorders (e.g., multiple sclerosis, Parkinson's disease), or systemic illnesses (e.g., inflammatory arthritis) affecting physical function
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
QEII Health Sciences Centre - Halifax Infirmary site
Halifax, Nova Scotia, Canada, B3H3A7
Actively Recruiting
Research Team
A
Andrew Glennie, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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