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CompletedNCT02617563MASTERS-D2Updated Jan 21, 2026Results posted

5-Year Global Study on MAST™ Minimally Invasive Fusion Procedures to Treat Degenerative Lumbar Spine (MASTERS-D2)

An observational study in Intervertebral Disc Degeneration, sponsored by Medtronic Spinal and Biologics. Completed at 27 sites in 17 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-21.

Sponsored by Medtronic Spinal and Biologics · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
361
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is

  • to evaluate the effectiveness of MAST techniques for anterior/lateral and posterior approaches in Degenerative Disc Disease (DDD) patients with spondylolisthesis (≥ grade I).
  • To assess how single or double level MAST(Minimal Access Spinal Technologies) fusion procedures PLIF (Posterior Lumbar Interbody Fusion), TLIF (Transforaminal Lumbar Interbody Fusion), DLIF (Direct Lateral Interbody Fusion), OLIF (Oblique Lumbar Interbody Fusion), ALIF (Anterior Lumbar Interbody Fusion), or MIDLF (Midline Lumbar Interbody Fusion) are used in surgical practice and to describe long-term safety and effectiveness in a broad patient population of patients with degenerative lumbar disc disease .
Read the detailed description

In this Prospective, Global (multi center), Post Market Release (PMR) Study, Patients will be submitted to a single or double level instrumented fusion procedure using a PLIF, TLIF, ALIF, OLIF, DLIF or MIDLF technique via a minimally invasive procedure and will receive the same medical treatment as if they would not participate in this study.

  • The study will be monitored with visits conducted at the start, during and at the closure of the clinical study.
  • MedDRA coding will be used to classify the Adverse Event.
  • The study will be conducted according to Medtronic SOPs
  • Sample size calculation: Assuming that the standard deviation for ODI improvement at 3 months is 20 for both groups (anterolateral and posterior) and there is no difference in the mean ODI improvement at 3 months, with 80% power and 5% alpha level, the sample size for the primary endpoint (DDD patients operated for spondylolisthesis) is as follows in order to claim equivalence between two groups with equivalent margin (-10, 10):
  • Estimated sample size per group (anterolateral procedures versus posterior procedures): 70
  • Estimated total sample size for spondylolisthesis patients: 140
  • From the MASTERS-D study it is know that approximately 50% of the patients with degenerative disc disease have spondylolisthesis ≥ grade I. Hence the required total sample size is 140/0.5 = 280. The study is anticipated to enroll 350 patients.
  • In addition to a final statistical analysis, 3 months and annual interim analyses are anticipated.
  • The study hypothesis for the primary objective is to verify whether patients operated for spondylolisthesis (≥ grade I) have equivalent mean improvement of ODI at 3 months regardless of the minimally invasive surgical procedure (anterolateral or posterior) used.
  • The null-hypothesis: Ho: Δ ODI_Anterolateral ≠ Δ ODI_posterior
  • will be tested against the alternative hypothesis: HA: Δ ODI_Anterolateral = Δ ODI_posterior Where Δ ODI_Anterolateral is the average improvement in ODI score (baseline - 3 months) in spondylolisthesis subjects treated with the anterolateral approach and Δ ODI_posterior is the average improvement in ODI score (baseline - 3 months) in spondylolisthesis subjects treated with the posterior approach.
02

Conditions studied

  • Intervertebral Disc Degeneration

Keywords

  • spondylolisthesis
  • CD Horizon® Spinal Systems
  • minimal invasive
  • Spinal Fusion
  • MAST procedure
  • Lumbar fusion
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

361 patients suffering from lumbar degenerative disc disease (DDD) were enrolled over a period of 42 months in 27 sites located in Europe, Latin America, and Asia Pacific.

Inclusion criteria

  • Patient is ≥ 18 years of age (or minimum age as required by local regulations)
  • Patient has degenerative disc disease and an indication for a single or double level instrumented lumbar fusion for the treatment
  • Patient agrees to participate in the study and is able to sign the Data Release Form/Informed Consent
  • The procedure planned for the patient complies with the labeling of the Devices that may be used in the surgical procedure as described in the section Medical Devices of the Clinical Investigation Plan
  • Patient is planned to be submitted to a minimally invasive fusion procedure using a posterior (PLIF, TLIF, MIDLF) or anterolateral (OLIF, ALIF, DLIF ) technique*

    *For a double level instrumented fusion, the same procedure must be used for both levels.

  • The patient is willing and is able to perform study procedures and required follow-up visits.

Exclusion criteria

Exclusion Criteria:

  • Patient that has already undergone a lumbar fusion surgery
  • Patient that has already undergone open lumbar surgery other than standard decompression surgery
  • Indications for the procedure other than degenerative spine disease like: Osteoporotic vertebral fractures, Spine trauma fractures or Spine tumor
  • Illiterate or vulnerable patients (e.g. minors, participants incapable of judgment or participants under tutelage)
  • Concurrent participation in another clinical study that may confound study results.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
361 participants (actual)
Target follow-up
5 Years
Patient registry
Yes

Groups and cohorts

  • Minimally invasive lumbar fusion

    A single or double level instrumented fusion using minimally invasive PLIF, TLIF, MIDLF, DLIF, OLIF, ALIF procedures for the treatment of the degenerative lumbar spine.

    Device: Minimally invasive lumbar fusion

Interventions

  • DeviceMinimally invasive lumbar fusion

    Patients will receive a single or double level instrumented fusion using a minimally invasive/MAST™ PLIF, TLIF, DLIF, OLIF, ALIF or MIDLF surgical procedure with a posterior fixation. For the use of a posterior fixation system, the CD Horizon™ Spinal System, is mandatory in this study and will be either mini-open and/or percutaneous.

05

What researchers measure

Primary outcomes

  1. Change (Preop-postop) of Disability, Oswestry Disability Index (ODI) at 3 Months as Compared to Baseline in DDD Patients With Spondylolisthesis

    To demonstrate that DDD patients operated for spondylolisthesis fare equally well regardless of the surgical procedure (anterolateral or posterior) performed as measured by the change of ODI at 3 months as compared to baseline. ODI=Oswestry Disability Scale \[0-100\]; higher scores mean a worse outcome Timepoints: Baseline and 3 months

    Time frame: 3 months

Secondary outcomes

  1. Change (Preop-postop) in Disability ODI as Compared to Baseline in DDD Patients Without Spondylolisthesis

    To evaluate whether DDD patients without spondylolisthesis fare equally well regardless of the surgical procedure (anterolateral or posterior) performed, as measured by Oswestry Disability Index (ODI) at 3 months. Scored \[0-100\]; higher scores mean a worse outcome Timepoints: Baseline and 3 months

    Time frame: 3 months

  2. Change (Preop-postop) in ODI Scores for the Total Population

    To observe the change in ODI scores as compared to baseline through 5 years. The score at baseline gives the baseline score \[0-100\]; the higher the score, the worse the outcome. Additional scores are based on the change from baseline. The higher the score, the greater the improvement. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

    Time frame: Through 5 years

  3. Change (Preop-postop) in Visual Analog Scale (VAS) Back Pain Intensity

    To observe a change in VAS back pain as compared to baseline through 5 years. At baseline scored on a scale from \[0-10\]; 0 = No pain 10= Worst pain possible. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

    Time frame: Through 5 years

  4. Change (Preop-postop) in VAS Leg Pain Intensity

    To observe the change in VAS leg pain as compared to baseline through 5 years. The score at baseline gives the baseline score \[0-10\]; 0 = No pain 10= Worst pain possible. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

    Time frame: Through 5 years

  5. Change (Postop-preop) in EQ-5D Index Score

    To observe the change in EuroQol-5 Dimension (EQ-5D) index score as compared to baseline through 5 years. Scored from \[-0.109 to 1\]. A higher score means a better outcome. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

    Time frame: Through 5 years

  6. The Neurological Success Rate

    Neurological status is based on four types of measurements (sections): motor, sensory, reflexes, and straight leg raising. Overall neurological success is defined as maintenance or improvement in all sections (motor, sensory, reflex, and straight leg raising) for the time period evaluated. In order for a section to be considered a success, each element in the section must remain the same or improve from the time of the baseline evaluation to the time period evaluated. Therefore, if any one element in any section does not stay the same or improve, then a patient was not considered a success for neurological status.

    Time frame: 5 years

  7. Fusion Success

    Fusion success rate was summarized for at 1, 2, 3, 4, 5 year follow-up. If a participant showed fusion success at early time points and non-fusion at a later time point, the fusion status at all earlier points was considered as non-fusion. For 2-level fusion participants, fusion success was defined as achieving fusion at both treated levels.

    Time frame: Through 5 years

  8. Proportion of Patients Needing a Secondary Spinal Surgery at the Index and/or Adjacent Level(s) (Reoperation Rates) Throughout the Study

    To document Secondary Surgeries at index and/or adjacent level(s)throughout the study. When a participant requires additional surgery at the index level(s), it can be an indicator of insufficient outcomes of the initial surgery. Due to the progressive nature of the degenerative lumbar spine, additional surgeries at the index and/or adjacent levels might be required after the initial surgery. To ensure all safety and economic values are collected, the revision surgeries and their complication types and rates will be assessed during the study by the surgeons. For secondary surgery at index levels and/or secondary surgery at adjacent levels, survival analysis was performed to estimate the cumulative event rate up to 5 years.

    Time frame: Through 5 years

  9. Adverse Events

    Document Adverse Events occurrence throughout the study

    Time frame: Through 5 years

  10. Amount of Days Needed for First Ambulation

    To observe and document the days needed for participants to get out of bed and ambulate with or without assistance. Time range: \[0-11\] days

    Time frame: From surgery up to hospital discharge, up to 11 days

  11. Amount of Days Needed to Recover From Surgery

    To observe and document the days after the surgery, fulfilling following criteria: * No need for intravenous infusion of analgesic drugs * No ongoing surgery related adverse events impending discharge * No need for nursing care Timeframe: \[0-46\] days The objective of the Surgery Recovery Day assessment is to collect the day when the participant could be discharged based on his actual clinical condition because the effective day of discharge may be prolonged by factors other than the participant's clinical recovery such as social factors or co-morbidity. For the purpose of reporting these parameters the day of the surgery were considered 'D0', the first day after surgery as 'D1', the second day as 'D2' and so on.

    Time frame: Surgery Recovery Day up to hospital discharge, with a maximum of 46 days

  12. Healthcare Economics Evaluation "Medications"

    Healthcare utilization were measured with the following three costs components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Baseline to 5-year follow-up

  13. Health Economics Evaluation "Resources"

    Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Through 5 years

  14. Health Economics Evaluation "Rehabilitation Program"

    Healthcare utilization is measured with the following three costs components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Baseline to 5 years

  15. Health Economics Evaluation "Operative Time"

    Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Peri-operative

  16. Health Economics Evaluation "Estimated Blood Loss"

    Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Peri-operative

  17. Health Economics Evaluation "Length of Hospital Stay"

    Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program The minimum-maximum time spent at the hospital was \[1-53 days\]

    Time frame: Post-operative, up to 53 days

  18. Health Economics Evaluation "Total Fluoroscopy Time"

    Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

    Time frame: Peri-operative

  19. To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Categorical Variables

    To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

    Time frame: Baseline

  20. To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Age

    To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

    Time frame: Baseline

  21. To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Height

    To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

    Time frame: Baseline

  22. To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Weight

    To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

    Time frame: Baseline

  23. To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - BMI

    To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

    Time frame: Baseline

06

Results

Posted Jan 21, 2026

Participant flow

4 Weeks
Participant flow — 4 Weeks
MilestoneTotal Population ANTTotal Population POST
Started164173
Completed162173
Not completed20
Withdrew: Withdrawal by subject20
3 Months
Participant flow — 3 Months
MilestoneTotal Population ANTTotal Population POST
Started162173
Completed161172
Not completed11
Withdrew: Lost to follow-up10
Withdrew: Withdrawal by subject01
1 Year
Participant flow — 1 Year
MilestoneTotal Population ANTTotal Population POST
Started161172
Completed160170
Not completed12
Withdrew: Lost to follow-up12
2 Year
Participant flow — 2 Year
MilestoneTotal Population ANTTotal Population POST
Started160170
Completed157165
Not completed35
Withdrew: Death10
Withdrew: Lost to follow-up21
Withdrew: Withdrawal by subject04
3 Year
Participant flow — 3 Year
MilestoneTotal Population ANTTotal Population POST
Started157165
Completed153160
Not completed45
Withdrew: Death21
Withdrew: Lost to follow-up13
Withdrew: Withdrawal by subject11
4 Year
Participant flow — 4 Year
MilestoneTotal Population ANTTotal Population POST
Started153160
Completed146158
Not completed72
Withdrew: Death10
Withdrew: Lost to follow-up31
Withdrew: Withdrawal by subject31
5 Year
Participant flow — 5 Year
MilestoneTotal Population ANTTotal Population POST
Started146158
Completed136152
Not completed106
Withdrew: Death01
Withdrew: Lost to follow-up95
Withdrew: Withdrawal by subject10

Outcome measures

PrimaryChange (Preop-postop) of Disability, Oswestry Disability Index (ODI) at 3 Months as Compared to Baseline in DDD Patients With Spondylolisthesis

To demonstrate that DDD patients operated for spondylolisthesis fare equally well regardless of the surgical procedure (anterolateral or posterior) performed as measured by the change of ODI at 3 months as compared to baseline. ODI=Oswestry Disability Scale \[0-100\]; higher scores mean a worse outcome Timepoints: Baseline and 3 months

Time frame:
3 months
Reported as:
Mean · change of score on a scale (ODI)
Change (Preop-postop) of Disability, Oswestry Disability Index (ODI) at 3 Months as Compared to Baseline in DDD Patients With Spondylolisthesis
change of score on a scale (ODI)Spondylolisthesis ANTSpondylolisthesis POST
Change (Preop-postop) of Disability, Oswestry Disability Index (ODI) at 3 Months as Compared to Baseline in DDD Patients With Spondylolisthesis23.19 ± 21.3226.08 ± 19.47
Statistical analysis
  • Spondylolisthesis ANT vs Spondylolisthesis POST · ANCOVA · p = 0.426 · Difference of least square means: -1.76 · 95% CI -6.11 to 2.59
SecondaryChange (Preop-postop) in Disability ODI as Compared to Baseline in DDD Patients Without Spondylolisthesis

To evaluate whether DDD patients without spondylolisthesis fare equally well regardless of the surgical procedure (anterolateral or posterior) performed, as measured by Oswestry Disability Index (ODI) at 3 months. Scored \[0-100\]; higher scores mean a worse outcome Timepoints: Baseline and 3 months

Time frame:
3 months
Reported as:
Mean · score on a scale (improvement)
Change (Preop-postop) in Disability ODI as Compared to Baseline in DDD Patients Without Spondylolisthesis
score on a scale (improvement)Non-spondylolisthesis ANTNon-spondylolisthesis POST
Change (Preop-postop) in Disability ODI as Compared to Baseline in DDD Patients Without Spondylolisthesis13.41 ± 22.0924.20 ± 20.02
SecondaryChange (Preop-postop) in ODI Scores for the Total Population

To observe the change in ODI scores as compared to baseline through 5 years. The score at baseline gives the baseline score \[0-100\]; the higher the score, the worse the outcome. Additional scores are based on the change from baseline. The higher the score, the greater the improvement. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

Time frame:
Through 5 years
Reported as:
Mean · score on a scale (improvement)
Change (Preop-postop) in ODI Scores for the Total Population
score on a scale (improvement)Total Population ANTTotal Population POST
Baseline (score)46.46 ± 18.0547.02 ± 15.89
4 Weeks13.27 ± 22.5617.57 ± 19.87
3 Months20.23 ± 21.9525.43 ± 19.62
1 Year24.47 ± 22.3029.42 ± 19.63
2 Year27.80 ± 23.8130.31 ± 20.52
3 Year27.15 ± 23.9329.83 ± 21.08
4 Year26.08 ± 25.4827.30 ± 21.01
5 Year26.55 ± 25.5029.26 ± 19.67
SecondaryChange (Preop-postop) in Visual Analog Scale (VAS) Back Pain Intensity

To observe a change in VAS back pain as compared to baseline through 5 years. At baseline scored on a scale from \[0-10\]; 0 = No pain 10= Worst pain possible. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

Time frame:
Through 5 years
Reported as:
Mean · score on a scale
Change (Preop-postop) in Visual Analog Scale (VAS) Back Pain Intensity
score on a scaleTotal Population ANTTotal Population POST
Baseline (score)6.48 ± 2.335.76 ± 2.76
4 Weeks3.48 ± 3.153.06 ± 3.06
3 Months3.47 ± 3.113.25 ± 3.23
1 Year3.48 ± 3.363.46 ± 3.01
2 Year3.50 ± 3.403.59 ± 3.01
3 Year3.54 ± 3.263.54 ± 2.92
4 Year3.42 ± 3.393.33 ± 3.04
5 Year3.90 ± 3.253.48 ± 2.93
SecondaryChange (Preop-postop) in VAS Leg Pain Intensity

To observe the change in VAS leg pain as compared to baseline through 5 years. The score at baseline gives the baseline score \[0-10\]; 0 = No pain 10= Worst pain possible. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

Time frame:
Through 5 years
Reported as:
Mean · score on a scale (improvement)
Change (Preop-postop) in VAS Leg Pain Intensity
score on a scale (improvement)Total Population ANTTotal Population POST
Baseline (score)6.18 ± 2.706.33 ± 2.57
4 Weeks3.79 ± 3.584.64 ± 3.25
3 Months3.99 ± 3.564.76 ± 3.44
1 Year3.83 ± 3.704.50 ± 3.57
2 Year4.17 ± 3.814.84 ± 3.49
3 Year4.18 ± 3.734.62 ± 3.51
4 Year3.58 ± 4.104.52 ± 3.50
5 Year4.23 ± 3.694.65 ± 3.40
SecondaryChange (Postop-preop) in EQ-5D Index Score

To observe the change in EuroQol-5 Dimension (EQ-5D) index score as compared to baseline through 5 years. Scored from \[-0.109 to 1\]. A higher score means a better outcome. Timepoints: Baseline, 4 weeks, 3 months, 1-,2-,3-,4-, and 5-years

Time frame:
Through 5 years
Reported as:
Mean · score on a scale (improvement)
Change (Postop-preop) in EQ-5D Index Score
score on a scale (improvement)Total Population ANTTotal Population POST
Baseline (score)0.492 ± 0.2250.543 ± 0.226
4 Weeks0.209 ± 0.2710.237 ± 0.246
3 Months0.267 ± 0.2680.285 ± 0.248
1 Year0.261 ± 0.2830.287 ± 0.239
2 Year0.307 ± 0.2860.314 ± 0.257
3 Year0.301 ± 0.2910.315 ± 0.247
4 Year0.284 ± 0.3160.286 ± 0.249
5 Year0.300 ± 0.3060.291 ± 0.249
SecondaryThe Neurological Success Rate

Neurological status is based on four types of measurements (sections): motor, sensory, reflexes, and straight leg raising. Overall neurological success is defined as maintenance or improvement in all sections (motor, sensory, reflex, and straight leg raising) for the time period evaluated. In order for a section to be considered a success, each element in the section must remain the same or improve from the time of the baseline evaluation to the time period evaluated. Therefore, if any one element in any section does not stay the same or improve, then a patient was not considered a success for neurological status.

Time frame:
5 years
Reported as:
Count of participants · Participants
The Neurological Success Rate
ParticipantsTotal Population ANTTotal Population POST
Motor function — Normal5258
Motor function — Abnormal21
Sensory function — Normal5357
Sensory function — Abnormal12
Reflexes — Normal5458
Reflexes — Abnormal01
Straight leg raise — Normal5359
Straight leg raise — Abnormal10
Overall Neurological Status — Normal5156
Overall Neurological Status — Abnormal33
SecondaryFusion Success

Fusion success rate was summarized for at 1, 2, 3, 4, 5 year follow-up. If a participant showed fusion success at early time points and non-fusion at a later time point, the fusion status at all earlier points was considered as non-fusion. For 2-level fusion participants, fusion success was defined as achieving fusion at both treated levels.

Time frame:
Through 5 years
Reported as:
Count of participants · Participants
Fusion Success
ParticipantsTotal Population ANTTotal Population POST
12 Months — Fused110100
12 Months — Not Fused1716
24 Months — Fused3325
24 Months — Not Fused23
36 Months — Fused1918
36 Months — Not Fused13
48 Months — Fused1320
48 Months — Not Fused10
60 Months — Fused1218
60 Months — Not Fused10
The Last Evaluation of Fusion Status — Fused127115
The Last Evaluation of Fusion Status — Not Fused1615
SecondaryProportion of Patients Needing a Secondary Spinal Surgery at the Index and/or Adjacent Level(s) (Reoperation Rates) Throughout the Study

To document Secondary Surgeries at index and/or adjacent level(s)throughout the study. When a participant requires additional surgery at the index level(s), it can be an indicator of insufficient outcomes of the initial surgery. Due to the progressive nature of the degenerative lumbar spine, additional surgeries at the index and/or adjacent levels might be required after the initial surgery. To ensure all safety and economic values are collected, the revision surgeries and their complication types and rates will be assessed during the study by the surgeons. For secondary surgery at index levels and/or secondary surgery at adjacent levels, survival analysis was performed to estimate the cumulative event rate up to 5 years.

Time frame:
Through 5 years
Reported as:
Number · number of revision surgeries
Proportion of Patients Needing a Secondary Spinal Surgery at the Index and/or Adjacent Level(s) (Reoperation Rates) Throughout the Study
number of revision surgeriesTotal Population ANTTotal Population POST
Index levels only613
Adjacent levels only48
Both index and adjacent levels22
Others61
SecondaryAdverse Events

Document Adverse Events occurrence throughout the study

Time frame:
Through 5 years
Reported as:
Number · Adverse Events (n)
Adverse Events
Adverse Events (n)Total Population ANTTotal Population POST
Device-related105
MAST/MI (minimally invasive)-related1817
General Surgery-related6675
Disease-related6361
SecondaryAmount of Days Needed for First Ambulation

To observe and document the days needed for participants to get out of bed and ambulate with or without assistance. Time range: \[0-11\] days

Time frame:
From surgery up to hospital discharge, up to 11 days
Reported as:
Mean · Days
Amount of Days Needed for First Ambulation
DaysTotal Population ANTTotal Population POST
Amount of Days Needed for First Ambulation1.6 ± 1.31.9 ± 1.6
SecondaryAmount of Days Needed to Recover From Surgery

To observe and document the days after the surgery, fulfilling following criteria: * No need for intravenous infusion of analgesic drugs * No ongoing surgery related adverse events impending discharge * No need for nursing care Timeframe: \[0-46\] days The objective of the Surgery Recovery Day assessment is to collect the day when the participant could be discharged based on his actual clinical condition because the effective day of discharge may be prolonged by factors other than the participant's clinical recovery such as social factors or co-morbidity. For the purpose of reporting these parameters the day of the surgery were considered 'D0', the first day after surgery as 'D1', the second day as 'D2' and so on.

Time frame:
Surgery Recovery Day up to hospital discharge, with a maximum of 46 days
Reported as:
Mean · Days
Amount of Days Needed to Recover From Surgery
DaysTotal Population ANTTotal Population POST
Amount of Days Needed to Recover From Surgery4.4 ± 3.75.0 ± 5.2
SecondaryHealthcare Economics Evaluation "Medications"

Healthcare utilization were measured with the following three costs components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Baseline to 5-year follow-up
Reported as:
Count of participants · Participants
Healthcare Economics Evaluation "Medications"
ParticipantsTotal Population ANTTotal Population POST
Baseline : Nonopioid analgesics — Yes121101
Baseline : Nonopioid analgesics — No4372
Baseline : Opioid analgesics — Yes7049
Baseline : Opioid analgesics — No94124
Baseline : Other medications — Yes8337
Baseline : Other medications — No81136
4 Weeks : Nonopioid analgesics — Yes9989
4 Weeks : Nonopioid analgesics — No5568
4 Weeks : Opioid analgesics — Yes5342
4 Weeks : Opioid analgesics — No101115
4 Weeks : Other medications — Yes7532
4 Weeks : Other medications — No79125
3 Months : Nonopioid analgesics — Yes9768
3 Months : Nonopioid analgesics — No6292
3 Months : Opioid analgesics — Yes4829
3 Months : Opioid analgesics — No111131
3 Months : Other medications — Yes6723
3 Months : Other medications — No92137
1 Year : Nonopioid analgesics — Yes7353
1 Year : Nonopioid analgesics — No79105
1 Year : Opioid analgesics — Yes2916
1 Year : Opioid analgesics — No123142
1 Year : Other medications — Yes5524
1 Year : Other medications — No97134
2 Year : Nonopioid analgesics — Yes5648
2 Year : Nonopioid analgesics — No91109
2 Year : Opioid analgesics — Yes2416
2 Year : Opioid analgesics — No123141
2 Year : Other medications — Yes5027
2 Year : Other medications — No97130
3 Year : Nonopioid analgesics — Yes5748
3 Year : Nonopioid analgesics — No87106
3 Year : Opioid analgesics — Yes188
3 Year : Opioid analgesics — No126146
3 Year : Other medications — Yes4623
3 Year : Other medications — No98131
4 Year : Nonopioid analgesics — Yes4445
4 Year : Nonopioid analgesics — No89107
4 Year : Opioid analgesics — Yes2110
4 Year : Opioid analgesics — No112142
4 Year : Other medications — Yes3826
4 Year : Other medications — No95126
5 Year : Nonopioid analgesics — Yes3841
5 Year : Nonopioid analgesics — No97110
5 Year : Opioid analgesics — Yes2010
5 Year : Opioid analgesics — No115141
5 Year : Other medications — Yes3429
5 Year : Other medications — No101122
SecondaryHealth Economics Evaluation "Resources"

Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Through 5 years
Reported as:
Mean · Number of occurrences
Health Economics Evaluation "Resources"
Number of occurrencesTotal Study Population ANTTotal Study Population POST
Nr of times patient received care in outpatient centre due to back pain at 5 years2.2 ± 1.63.6 ± 3.6
Nr of times patient received care in primary care service due to back pain at 5 years1.8 ± 0.52.2 ± 1.1
SecondaryHealth Economics Evaluation "Rehabilitation Program"

Healthcare utilization is measured with the following three costs components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Baseline to 5 years
Reported as:
Count of participants · Participants
Health Economics Evaluation "Rehabilitation Program"
ParticipantsTotal Population ANTTotal Population POST
Discharge :Will the patient be transferred to a Rehabilitation center? — Yes96
Discharge :Will the patient be transferred to a Rehabilitation center? — No154167
Discharge : Rehabilitation care at home — Yes2221
Discharge : Rehabilitation care at home — No141152
Discharge : Care at an outpatient rehabilitation center — Yes1542
Discharge : Care at an outpatient rehabilitation center — No148131
4 Weeks: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes208
4 Weeks: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No134149
4 Weeks : Rehab center — Yes43
4 Weeks : Rehab center — No155
4 Weeks : Rehabilitation care at home — Yes111
4 Weeks : Rehabilitation care at home — No87
4 Weeks : Care at an outpatient rehabilitation center — Yes55
4 Weeks : Care at an outpatient rehabilitation center — No143
3 Months: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes3436
3 Months: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No125124
3 Months : Rehab center — Yes69
3 Months : Rehab center — No2827
3 Months : Rehabilitation care at home — Yes36
3 Months : Rehabilitation care at home — No3130
3 Months : Care at an outpatient rehabilitation center — Yes2722
3 Months : Care at an outpatient rehabilitation center — No714
1 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes2727
1 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No125131
1 Year : Rehab center — Yes128
1 Year : Rehab center — No1518
1 Year : Rehabilitation care at home — Yes21
1 Year : Rehabilitation care at home — No2525
1 Year : Care at an outpatient rehabilitation center — Yes2218
1 Year : Care at an outpatient rehabilitation center — No58
2 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes99
2 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No138148
2 Year : Rehab center — Yes12
2 Year : Rehab center — No87
2 Year : Rehabilitation care at home — Yes10
2 Year : Rehabilitation care at home — No89
2 Year : Care at an outpatient rehabilitation center — Yes77
2 Year : Care at an outpatient rehabilitation center — No22
3 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes69
3 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No139145
3 Year : Rehab center — Yes23
3 Year : Rehab center — No45
3 Year : Rehabilitation care at home — Yes20
3 Year : Rehabilitation care at home — No48
3 Year : Care at an outpatient rehabilitation center — Yes25
3 Year : Care at an outpatient rehabilitation center — No43
4 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes310
4 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No130142
4 Year : Rehab center — Yes03
4 Year : Rehab center — No37
4 Year : Rehabilitation care at home — Yes01
4 Year : Rehabilitation care at home — No39
4 Year : Care at an outpatient rehabilitation center — Yes36
4 Year : Care at an outpatient rehabilitation center — No04
5 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — Yes43
5 Year: Any Rehabilitation Program Between This Scheduled Visit and the Previous Scheduled Visit — No131148
5 Year : Rehab center — Yes11
5 Year : Rehab center — No32
5 Year : Rehabilitation care at home — Yes01
5 Year : Rehabilitation care at home — No42
5 Year : Care at an outpatient rehabilitation center — Yes31
5 Year : Care at an outpatient rehabilitation center — No12
SecondaryHealth Economics Evaluation "Operative Time"

Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Peri-operative
Reported as:
Mean · hours
Health Economics Evaluation "Operative Time"
hoursTotal Population ANTTotal Population POST
Health Economics Evaluation "Operative Time"3.371 ± 1.2792.860 ± 1.028
SecondaryHealth Economics Evaluation "Estimated Blood Loss"

Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Peri-operative
Reported as:
Mean · ml
Health Economics Evaluation "Estimated Blood Loss"
mlTotal Population ANTTotal Population POST
Health Economics Evaluation "Estimated Blood Loss"148.2 ± 201.5296.3 ± 238.7
SecondaryHealth Economics Evaluation "Length of Hospital Stay"

Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program The minimum-maximum time spent at the hospital was \[1-53 days\]

Time frame:
Post-operative, up to 53 days
Reported as:
Mean · Days
Health Economics Evaluation "Length of Hospital Stay"
DaysTotal Population ANTTotal Population POST
Health Economics Evaluation "Length of Hospital Stay"6.6 ± 5.47.5 ± 5.9
SecondaryHealth Economics Evaluation "Total Fluoroscopy Time"

Healthcare utilization is measured with the following three cost components: 1. resources: surgery room, length of hospital stay, additional medical visits (outpatient consultations, visits to primary care services, etc) 2. medications 3. non-pharmacologic therapies: rehabilitation program

Time frame:
Peri-operative
Reported as:
Mean · seconds
Health Economics Evaluation "Total Fluoroscopy Time"
secondsTotal Population ANTTotal Population POST
Health Economics Evaluation "Total Fluoroscopy Time"144.8 ± 151.0143.5 ± 202.9
SecondaryTo Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Categorical Variables

To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

Time frame:
Baseline
Reported as:
Count of participants · Participants
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Categorical Variables
ParticipantsALIFDLIFOLIFPLIFMIDLFTLIF
Gender: Female? — Yes202753114349
Gender: Female? — No232318112237
Does the patient currently use tobacco? — Yes1810106621
Does the patient currently use tobacco? — No254061165965
Preoperative work status: Employed/independent worker? — Yes27222492322
Preoperative work status: Employed/independent worker? — No162847134264
SecondaryTo Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Age

To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

Time frame:
Baseline
Reported as:
Mean · years
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Age
yearsALIFDLIFOLIFPLIFMIDLFTLIF
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Age49.4 ± 9.559.5 ± 9.060.5 ± 9.254.5 ± 10.861.3 ± 10.659.8 ± 11.3
SecondaryTo Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Height

To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

Time frame:
Baseline
Reported as:
Mean · centimeter (cm)
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Height
centimeter (cm)ALIFDLIFOLIFPLIFMIDLFTLIF
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Height169.4 ± 9.0167.5 ± 9.6162.3 ± 8.7167.3 ± 8.1164.0 ± 10.4164.2 ± 8.2
SecondaryTo Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Weight

To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

Time frame:
Baseline
Reported as:
Mean · kilogram (kg)
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Weight
kilogram (kg)ALIFDLIFOLIFPLIFMIDLFTLIF
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - Weight77.2 ± 15.282.3 ± 15.571.4 ± 13.880.9 ± 15.375.2 ± 18.669.4 ± 13.1
SecondaryTo Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - BMI

To observe and document the patient profile when choosing a particular minimally invasive fusion procedure: Baseline information is summarized for all DDD patients per surgical procedure (ALIF, OLIF, DLIF, PLIF, TLIF, MIDLF).

Time frame:
Baseline
Reported as:
Mean · kg/m2
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - BMI
kg/m2ALIFDLIFOLIFPLIFMIDLFTLIF
To Observe and Document the Patient Profile When Choosing a Particular Minimally Invasive Fusion Procedure - BMI26.8 ± 4.229.4 ± 5.627.0 ± 4.328.9 ± 5.027.7 ± 5.125.6 ± 3.5

Adverse events

Collected over The data was collected from Baseline until the 5-year follow-up visit.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Total Population ANT4/164 (2.4%)58/164 (35.4%)56/164 (34.1%)
Total Population POST2/173 (1.2%)55/173 (31.8%)43/173 (24.9%)
Most frequent serious events
Showing 10 of 119
Most frequent serious events
EventTotal Population ANTTotal Population POST
OsteoarthritisMusculoskeletal and connective tissue disorders11/1645/173
Adjacent segment degenerationInjury, poisoning and procedural complications2/1645/173
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders4/1643/173
CataractEye disorders0/1644/173
Wrong technique in device usage processInjury, poisoning and procedural complications2/1644/173
Humerus fractureInjury, poisoning and procedural complications3/1640/173
Vertebral foraminal stenosisMusculoskeletal and connective tissue disorders2/1643/173
AnaemiaBlood and lymphatic system disorders2/1640/173
Muscular weaknessMusculoskeletal and connective tissue disorders2/1640/173
OsteonecrosisMusculoskeletal and connective tissue disorders2/1640/173
Most frequent other events
Most frequent other events
EventTotal Population ANTTotal Population POST
Back painMusculoskeletal and connective tissue disorders31/16416/173
Procedural painInjury, poisoning and procedural complications18/1644/173
PyrexiaGeneral disorders3/16418/173
Pain in extremityMusculoskeletal and connective tissue disorders12/1642/173
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders2/16410/173

Baseline characteristics

Age, Continuous
Age, Continuous(years)Total Population ANTTotal Population POSTTotal
Mean57.3 ± 10.359.7 ± 11.158.5 ± 10.8
Sex: Female, Male
Sex: Female, Male(Participants)Total Population ANTTotal Population POSTTotal
Female100103203
Male6470134
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Total Population ANTTotal Population POSTTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Total Population ANTTotal Population POSTTotal
Argentina336
Czechia01313
United Kingdom111728
Portugal172239
Spain39241
Russia221234
South Korea262349
Austria9514
Belgium088
China04848
Denmark112
Brazil7310
Italy112
Mexico011
Slovakia033
France28735
Germany044
BMI (kg/m^2)
BMI (kg/m^2)(kg/m^2)Total Population ANTTotal Population POSTTotal
Mean27.7 ± 4.926.8 ± 4.527.2 ± 4.7
Current tobacco use
Current tobacco use(Participants)Total Population ANTTotal Population POSTTotal
Uses tobacco383371
Does not use tobacco126140266
Working status
Working status(Participants)Total Population ANTTotal Population POSTTotal
Not employed91119210
Employed or independent worker7354127
History of spine surgery
History of spine surgery(Participants)Total Population ANTTotal Population POSTTotal
Yes201535
No144158302

3 further baseline measures are reported on the registry.

07

Study locations

27 sites
  • Hospital Italiano de Buenos Aires
    Buenos Aires, C1199ABD, Argentina
  • Kepler Universitatsklinikum
    Linz, 4020, Austria
  • AZ Delta
    Roeselare, 8800, Belgium
  • Hospital Universitario Cajuru
    Curitiba, 80050-350, Brazil
  • The First Affiliated Hospital of Dalian Medical University
    Dalian, Liaoning 116011, China
  • West China Hospital Sichuan University
    Chengdu, Sichuan 610041, China
  • Shangai Tenth People's Hospital
    Shanghai, 200072, China
  • Nový Hradec Králové
    Hradec Králové, 500 05, Czechia
  • Glostrup Hospital
    Glostrup Municipality, 2600, Denmark
  • Hôpital Civil de Strasbourg (NHC)
    Eckbolsheim, 67201, France
  • CHRU de Lille, Hôpital Roger Salengro
    Lille, 59037, France
  • Service de Neurochirurgie la Timone
    Marseille, France
  • Klinikum Magdeburg
    Magdeburg, 39130, Germany
  • A.O. Fatebenefratelli e Oftalmico
    Milan, 20123, Italy
  • Hospital Naval General de Alta Especialidad
    Mexico City, 4470, Mexico
  • Hospital Escala Braga
    Braga, 4710-243, Portugal
  • Centro Hospitalar de Sao Joao
    Porto, 4200-319, Portugal
  • Nizhny Novgorod Research Institute of Traumatology and Orthopedics of Public Health Ministry
    Nizhny Novgorod, 603155, Russia
  • Scientific Research Institute of Traumatology and Orthopedics
    Novosibirsk, 630091, Russia
  • A-klinik
    Bratislava, 82108, Slovakia
  • Department of Orthopedics, Korea University Ansan Hospital
    Ansan, 425-707, South Korea
  • National Health Insurance Corporation Ilsan Hospital
    Gyeonggi-do, 10444, South Korea
  • Department of Neurological Surgery, Chung-Ang University Hospital
    Seoul, 156-755, South Korea
  • Hospital Universitario Marques de Valdecilla
    Santander, 39008, Spain
  • Hospital L'Horta Manises
    Valencia, 46026, Spain
  • Hull Royal Infirmary
    Hull, HU3 2JZ, United Kingdom
  • East Suffolk and North Essex NHS Foundation Trust (was formerly Ipswich Hospital NHS)
    Ipswich, IP45PD, United Kingdom
08

References and documents

Study documents

  • Study protocol · Feb 22, 2019
  • Statistical analysis plan · Apr 22, 2019

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT02617563
Lead sponsor
Medtronic Spinal and Biologics
Responsible party
Sponsor
First posted
Dec 1, 2015
Start date
Dec 2015
Primary completion
Nov 10, 2019
Completion
Nov 14, 2024
Results posted
Jan 21, 2026
Last update
Jan 21, 2026

Oversight

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

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