Adding CORUS-LX to two-level (L4–S1) lumbar fusion

Post-market Safety and Effectiveness of the CORUS-LX System in Improving Lumbar Interbody Fusion Outcomes for the Treatment of Degenerative Lumbosacral Disc Disease.

This trial will test whether adding the CORUS-LX device to standard surgery helps adults having two-level (L4–S1) lumbar fusion for degenerative disc disease and radiculopathy.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 250 (estimated)
• Ages: 18 Years to 80 Years
• Sex: All
• Sponsor: Providence Medical Technology, Inc. (Industry-sponsored)
• Locations: 8 sites (Scottsdale, Arizona and 7 other locations)
• Trial ID: NCT07222787 on ClinicalTrials.gov

What this trial studies

This is a randomized controlled, post-market trial comparing supplemental posterior fusion performed with the CORUS-LX device to each surgeon's standard posterior fusion technique in patients undergoing two-level L4–S1 interbody fusion. All participants receive percutaneous pedicle screw and rod fixation with navigation, and the trial uses multimodal imaging to determine fusion across the posterior anatomy. Primary endpoints include incidence of posterior arthrodesis and absence of major device-related adverse events, with additional outcomes tracking injections and revision surgery related to back or leg pain. Sites include tertiary and regional spine centers in Arizona and California and follow participants through imaging and clinical follow-up.

Who should consider this trial

Good fit: Adults 18–80 with symptomatic degenerative lumbosacral disc disease requiring two contiguous L4–S1 interbody fusion levels, Oswestry Disability Index >40, and who have failed conservative care are the intended participants.

Not a fit: Patients with single-level disease, higher-grade spondylolisthesis, active infection, or those who are not candidates for two-level L4–S1 fusion are unlikely to benefit from this device.

Why it matters

Potential benefit: If successful, adding CORUS-LX could increase rates of posterior fusion and reduce the need for repeat injections or revision surgery.

How similar studies have performed: Few rigorous randomized trials have directly tested posterior supplemental fusion devices; small case series and registries show possible benefit but high-quality evidence is limited.

Eligibility criteria

Inclusion Criteria:

1. Age 18-80 years (Skeletally Mature)
2. Indicated for lumbar interbody fusion for treatment of degenerative lumbosacral disease at two contiguous disc levels between L4-S1 as determined by the following:

   a) Diagnosis of radiculopathy of the lumbar spine, with pain, including at least one of the following: i) Leg and/or buttock pain, weakness, numbness, or paresthesia ii) Low back pain iii) Neurogenic claudication b) Radiographically determined pathology (CT, MRI, X-rays) at the levels to be treated correlating to primary symptoms including at least one of the following: i) Decreased disc height in comparison to a normal adjacent disc. ii) Degenerative instability ≤ grade 1 spondylolisthesis (\<25% slip). iii) Recurrent disc herniation. iv) Central and/or foraminal stenosis.
3. Oswestry Disability Index Score of \> 40/100 (Severe Disability).
4. Unresponsive to non-operative, conservative treatment (rest, heat, electrotherapy, physical therapy, chiropractic care and/or analgesics) for:

   1. At least six weeks from symptom onset; or
   2. Have the presence of progressive symptoms or signs of nerve root/ spinal cord compression despite continued non-operative conservative treatment.
5. Reported to be medically cleared for surgery.
6. Physically and mentally able and willing to comply with the Protocol, including the ability to read and complete required forms
7. Willing and able to adhere to the scheduled follow-up visits and requirements of the Protocol.
8. Written informed consent provided by subject.

Exclusion Criteria:

1. Any disease or condition that, in the investigator's opinion, would preclude accurate radiographic evaluation of any treated vertebrae (e.g. morbid obesity).
2. Any anatomy or condition that makes posterior fusion treatment infeasible (e.g. fused facets).
3. Has, in the Investigator's opinion, any disease or condition that would preclude accurate clinical evaluation (e.g. neuromuscular disorders).
4. Active systemic infection or infection at the operative site.
5. Anticipated treatment for active systemic infection, including HIV or Hepatitis C.
6. Previous trauma to any of the L3 to S1 levels resulting in significant bony or disco-ligamentous lumbar spine injury that may prevent device placements.
7. Prior instrumented surgery or pseudoarthrosis at the operative or adjacent levels.
8. Indicated for or history of laminectomy at any of the index or adjacent levels
9. Fixed or permanent neurologic deficit related to the target treatment levels that cannot be improved with surgery
10. Leg, buttocks, or back pain in the absence of other symptoms of radiculopathy or myeloradiculopathy justifying the need for surgical intervention.
11. Symptomatic disc degeneration requiring surgical intervention at more or less than two levels.
12. Diagnosis of spondylolisthesis, grade \>1.
13. Diagnosis of lytic spondylolisthesis
14. Diagnosis of iatrogenic, traumatic, or dysplastic spondylolisthesis
15. Congenital bony and/or spinal cord abnormalities affecting spinal stability.
16. Diagnosis of Paget's disease, osteomalacia or any other metabolic bone disease other than osteopenia.
17. Diagnosis of osteoporosis, defined as a previous DEXA bone density T-score of ≤-2.5.
18. Active malignancy or a history of any invasive malignancy (except non-melanoma skin cancer), unless treated with curative intent and without clinical signs or symptoms of the malignancy for at least five years.
19. Has an uncontrolled seizure disorder.
20. Cauda equina syndrome or neurogenic bowel/bladder dysfunction;
21. Use of epidural steroids within 14 days prior to surgery.
22. A concomitant condition requiring daily, high-dose oral steroids.

    High dose steroid use is defined as:
    1. Daily, chronic use of oral steroids of 5 mg/day or greater (steroid inhalers are not exclusionary).
    2. Use of short-term (less than 10 days) oral steroids at a daily dose greater than 40 mg within one month of the study procedure.
23. Long-term use (\>6 months) of opioids \>120 mg morphine equivalents.
24. Known allergy to titanium (Ti)
25. A current or recent history (≤1 year prior to screening) of substance abuse that required medical treatment.
26. Is pregnant, nursing, or interested in becoming pregnant within the next 3 years from the time of screening.
27. Participation as a subject in any other clinical studies involving medical devices or drugs in the last 30 days prior to surgery
28. A pending personal litigation relating to spinal injury (worker's compensation is not exclusionary).
29. Anticipated or potential relocation greater than 50 miles that may interfere with completion of follow-up examinations.
30. A mental illness or belongs to a vulnerable population, as determined by the investigator (e.g., prisoner or developmentally disabled), that would compromise ability to provide informed consent or compliance with follow-up requirements.

Where this trial is running

Scottsdale, Arizona and 7 other locations

• Barrow Brain & Spine — Scottsdale, Arizona, United States (Recruiting)
• HonorHealth Neurology — Scottsdale, Arizona, United States (Recruiting)
• California Spine — Los Angeles, California, United States (Recruiting)
• Orthopaedic Spine Institute — Hinsdale, Illinois, United States (Recruiting)
• Olympia Neurological Institute — Austin, Texas, United States (Not_yet_recruiting)
• Spine Physician Institute — Dallas, Texas, United States (Recruiting)
• American Neurospine Institute — Frisco, Texas, United States (Not_yet_recruiting)
• Huntsman Spine — Salt Lake City, Utah, United States (Recruiting)

Study contacts

• Study coordinator: Erik M Summerside, PhD

Conditions Radiculopathy Lumbar; Degenerative Lumbar Disc Disease