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CompletedNCT00965380TLFUpdated Oct 23, 2018

Trinity Evolution in Posterior or Transforaminal Lumbar Interbody Fusion (PLIF/TLIF)

An observational study in Degenerative Disc Disease, sponsored by Orthofix Inc.. Completed at 15 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-10-23.

Sponsored by Orthofix Inc. · Observational

Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
207
Ages
18 Years and older
Sex
All
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Study summary

The purpose of this study is to utilize Trinity Evolution in conjunction with an interbody spacer and supplemental posterior fixation of the surgeon's choice and to follow the patients to measure the clinical outcomes and rate of fusion. The hypothesis of the study is that Trinity Evolution combined with an interbody spacer and supplemental posterior fixation will result in fusion rates and clinical outcomes similar to those with other routinely used autograft and allograft materials including: fusion, improvement in pain and function, maintenance of lower extremity neurological function, and absence of serious adverse events related to the use of the Trinity Evolution product.

Read the detailed description

Degenerative disorders of the lumbar spine can lead to a multitude of clinical problems including back pain and/or leg pain secondary to nerve compression and/or deformity. When conservative (non-surgical) treatment fails after at least a 6 month period and/or non-operative treatment is not indicated, patients and physicians may turn to a surgical solution. Surgical options consist basically of decompressing nerves, correcting and/or stabilizing deformities if required and fusing the segment, depending on the clinical situation. The "gold standard" for aiding healing in spinal fusion surgeries is the harvesting of autograft from the patient's iliac crest and placing it in and around the segments of the spine that are intended to be fused. Autograft is considered the "gold standard" because it contains the essential elements required for successful bone grafting: osteogenesis, osteoconduction, and osteoinduction.

However, the morbidity of harvesting autograft has been well documented and includes chronic donor-site pain, infection, neurologic injury, blood loss, deformity, bowel injury, hernia, and prolonged surgical and hospitalization time. There are now a number of products on the market to minimize or replace the use of autograft. However, few of these products contain all three essential bone-forming elements (osteogenesis, osteoconduction, and osteoinduction) in a single, stand alone product.

Trinity Evolution is a novel, allogeneic cancellous bone matrix containing viable osteoprogenitor cells, mesenchymal stem cells and a demineralized cortical bone (DCB) component to provide the required osteoconduction, osteogenesis, and osteoinduction necessary for successful bone grafting. Preclinical studies with Trinity Evolution have demonstrated in-vitro and in-vivo safety and effectiveness. Trinity Evolution is considered an allograft and as such is a "minimally manipulated" tissue and is labeled for bone repair for spinal, orthopedic and podiatric indications where autograft is used. The dosage will be dependent upon the specific requirements of the case.

02

Conditions studied

  • Degenerative Disc Disease

Keywords

  • Trinity Evolution
  • Symptomatic lumbar degenerative disc disease
  • Posterior lumbar interbody fusion
  • Transforaminal lumbar interbody fusion
03

In context

Intervertebral Disc Degeneration

464 studies on the registry are indexed under Intervertebral Disc Degeneration; 98 are open to participants now.

This study's enrollment of 207 is above the median of 120 across 166 observational studies indexed under Intervertebral Disc Degeneration.

Browse Intervertebral Disc Degeneration studies →

Lead sponsor

Orthofix Inc. is the lead sponsor of 16 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients with symptomatic lumbar degenerative disc disease scheduled to undergo PLIF or TLIF.

Inclusion criteria

  • Symptomatic lumbar degenerative disc disease at 1 or 2 adjacent levels between L3 and S1
  • Patients with back and/or leg pain scheduled for stabilization with or without decompression via a TLIF or PLIF approach utilizing an interbody spacer and supplemental posterior fixation.
  • Greater than 18 years of age
  • Unresponsive to conservative care over a period of at least 6 months or has progressive neurological signs and/or symptoms of neurological compromise that mandate urgent surgical intervention
  • Willing and able to comply with the requirements of the protocol including follow-up requirements
  • Willing and able to sign a study specific informed consent.

Exclusion criteria

Exclusion Criteria:

  • Patients requiring surgical treatment other than at 1 or 2 adjacent levels between L3 and S1
  • Active local or systemic infection
  • Currently pregnant or considering becoming pregnant during the follow-up period
  • Active malignancy or having been on chemotherapy of any kind for a malignancy in the past 1 year
  • Use of any other bone graft or bone graft substitute in addition to or in place of Trinity Evolution matrix in and around the interbody spacer.
  • Use of adjunctive post-operative stimulation
  • Prior interbody surgery at the same level
  • Has a known history of hypersensitivity or anaphylactic reaction to dimethyl sulfoxide (DMSO).
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Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
207 participants (actual)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Fusion Rates for Trinity Evolution

    Time frame: Operative to 24 months follow-up

Secondary outcomes

  1. NDI relative improvement; VAS improvement; Maintenance or improvement of neurological function

    Time frame: Pre-op to 24 months follow-up

  2. Complication Rates for Trinity Evolution

    Time frame: Operative to 24 months

07

Study locations

15 sites
  • Boulder Neurosurgical Associates
    Boulder, Colorado 80304, United States
  • Total Spine Care
    Canton, Connecticut 06019, United States
  • Middlesex Orthopedic Surgeons
    Middletown, Connecticut 06457, United States
  • Center for Advanced Neuro and Spine
    New Britain, Connecticut 06051, United States
  • Optim Healthcare (Formerly Southeastern Orthopedic Center)
    Savannah, Georgia 31405, United States
  • Parkview Orthopaedic Group
    Palos Heights, Illinois 60463, United States
  • Willis Knighton Health System
    Shreveport, Louisiana 71105, United States
  • University of Michigan A. Alfred Taubman Health Care Center
    Ann Arbor, Michigan 48109, United States
  • Cooper University Neurological Institute
    Camden, New Jersey 08103, United States
  • Spine Surgery of Buffalo Niagara
    Niagara Falls, New York 14304, United States
  • Carolina NeuroSurgery & Spine
    Charlotte, North Carolina 28204, United States
  • Triangle Orthopaedic Associates
    Durham, North Carolina 27704, United States
  • Duke University
    Durham, North Carolina 27710, United States
  • Triangle Neurosurgery
    Raleigh, North Carolina 27607, United States
  • Tuckahoe Orthopedic Surgeons
    Richmond, Virginia 23226, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 23, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT00965380
Lead sponsor
Orthofix Inc.
Responsible party
Sponsor
First posted
Aug 25, 2009
Start date
Sep 2009
Primary completion
Nov 2014
Completion
Jan 2015
Last update
Oct 23, 2018

Study contacts

James T Ryaby, PhD
study director · Orthofix Inc.

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2018. You cannot join it, but the record below documents what was studied.

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