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NCT04980378

Post Approval Study Protocol for the Two Level Simplify® Cervical Artificial Disc

Completed Results posted Last updated 8 January 2026
What this trial tests

trial testing Simplify Disc in Cervical Degenerative Disc Disorder in 291 participants. Completed in 24 January 2024.

Timeline
1 August 2021
Primary endpoint
24 January 2024
24 January 2024

Quick facts

Lead sponsorNuVasive
StatusCompleted
Study typeOBSERVATIONAL
Enrollment291
Start date1 August 2021
Primary completion24 January 2024
Estimated completion24 January 2024
Sites18 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

NuVasive — full company profile →

Who can join

Eligibility, any sex, with Cervical Degenerative Disc Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Clinical Composite Success Primary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

Individual success for Simplify Disc was defined as follows: * Neck Disability Index (NDI) score improvement of at least 15 points from pre-operative; * Maintenance or improvement in neurological status; * No serious adverse event classified as implant associated or implant/surgical procedure associated; and * No additional surgical procedure classified as a "failure."

GroupValue95% CI
Simplify Disc127
ACDF: Historical ACDF control data84
Clinically Significant Improvement in One or More Radicular Symptoms or Myelopathy Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

An arm pain questionnaire was used to measure radicular symptoms and compare to baseline symptoms in the IDE study. Changes of at least 2 points on a 10-point scale were regarded as clinically significant (0=no pain; 10=worst pain)

GroupValue95% CI
Simplify Disc125
ACDF: Historical ACDF control data90
Health Survey; 36-Item Short Form Survey (SF-36) - Physical Component Score (PCS) Maintenance or Improvement Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

The PCS is a sub-score of the SF-36. The SF-36 is a multipurpose survey with 36 questions. The questions were combined, scored, and weighted to create two scores that provide glimpses into mental and physical functioning and overall health-related quality-of-life. Higher scores indicate better outcomes. Scores range from 0-50. Maintenance or improvement was defined as PCS(Postop) - PCS(Preop) ≥0.

GroupValue95% CI
Simplify Disc122
ACDF: Historical ACDF control data86
Simplify Disc13
ACDF: Historical ACDF control data18
Health Survey; 36-Item Short Form Survey (SF-36) - Mental Component Score (MCS) Maintenance or Improvement Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

The MCS is a sub-score of the SF-36. The SF-36 is a multipurpose survey with 36 questions. The questions were combined, scored, and weighted to create two scores that provide glimpses into mental and physical functioning and overall health-related quality-of-life. Higher scores indicate better outcomes. Scores range from 0-50. Maintenance or improvement was defined as PCS(Postop) - PCS(Preop) ≥0.

GroupValue95% CI
Simplify Disc110
ACDF: Historical ACDF control data80
Simplify Disc25
ACDF: Historical ACDF control data24
Dysphagia Handicap Index (DHI Scale) Secondary · Data through 24 months gathered in IDE (NCT03123549 with start date of 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-operative.

Dysphagia Handicap Index score for the Simplify Disc subjects at 60 months. A higher score is indicative of a less desirable outcome. It is scored 0-100. Data was not collected on DHI in the historical ACDF control group. Only Simplify Disc subjects are reported. This was pre-specified in the study design.

GroupValue95% CI
Simplify Disc7.1± 11.6
Patient Satisfaction Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

Patient satisfaction was assessed by survey based on the response to the statement "I am satisfied with the results of my surgery" at 60 months. Answer options ranged from definitely true to definitely false.

GroupValue95% CI
Simplify Disc116
ACDF: Historical ACDF control data77
Simplify Disc22
ACDF: Historical ACDF control data24
Simplify Disc3
ACDF: Historical ACDF control data4
Simplify Disc2
ACDF: Historical ACDF control data1
Physician's Perception Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

Results at 60 months were categorized by the physician's perception of the subject's condition (excellent, good, fair, or poor).

GroupValue95% CI
Simplify Disc126
ACDF: Historical ACDF control data57
Simplify Disc10
ACDF: Historical ACDF control data41
Simplify Disc5
ACDF: Historical ACDF control data8
Simplify Disc0
ACDF: Historical ACDF control data1
Change in Average Disc Height (Superior Index Level) Secondary · Data through 24 months gathered in IDE (NCT03123549 with start date of 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-operative.

Average disc height (superior index level) at 60 months was compared to the baseline measurement in the IDE study and the change was calculated. Measurements were scored by an independent core lab. Average disc height was calculated as the simple average of the anterior and posterior disc heights. Data was not collected on average disc height in the historical ACDF control group. Only Simplify Disc subjects are reported. This was pre-specified in the study design.

GroupValue95% CI
Simplify Disc1.10± 0.84
Change in Average Disc Height (Inferior Index Level) Secondary · Data through 24 months gathered in IDE (NCT03123549 with start date of 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-operative.

Average disc height (inferior index level) at 60 months was compared to the baseline measurement in the IDE study and the change was calculated. Measurements were scored by an independent core lab. Average disc height was calculated as the simple average of the anterior and posterior disc heights. Data was not collected on average disc height in the historical ACDF control group. Only Simplify Disc subjects are reported. This was pre-specified in the study design.

GroupValue95% CI
Simplify Disc0.81± 0.94
Adjacent Level Deterioration - Superior Adjacent Level Secondary · Data through 24 months gathered in IDE (NCT03123549 with start date of 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-operative.

Outcome reports the number and percentage of subjects with adjacent level disc degeneration (ALDD) above the index level based on X-ray images. Degeneration was graded as none (no degenerative changes), doubtful (Minimal osteophytosis only), minimal (Definite osteophytosis with some sclerosis of anterior part of vertebral plates), moderate (Marked osteophytosis and sclerosis of vertebral plates with slight narrowing of disk space), or severe (Large osteophytes, marked sclerosis of vertebral plates, and marked narrowing of disk space). Assessments were made by an independent core lab. Data was

GroupValue95% CI
Simplify Disc70
Simplify Disc41
Simplify Disc20
Simplify Disc5
Adjacent Level Deterioration - Inferior Adjacent Level Secondary · Data through 24 months gathered in IDE (NCT03123549 with start date of 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-operative.

Outcome reports the number and percentage of subjects with adjacent level disc degeneration (ALDD) below the index level based on X-ray images. Degeneration was graded as none (no degenerative changes), doubtful (Minimal osteophytosis only), minimal (Definite osteophytosis with some sclerosis of anterior part of vertebral plates), moderate (Marked osteophytosis and sclerosis of vertebral plates with slight narrowing of disk space), or severe (Large osteophytes, marked sclerosis of vertebral plates, and marked narrowing of disk space). Assessments were made by an independent core lab. Data was

GroupValue95% CI
Simplify Disc81
Simplify Disc23
Simplify Disc13
Simplify Disc5
Displacement or Migration of the Device Secondary · Data through 24 months gathered in IDE (NCT03123549; start date 4/1/17). This PAS (start date 8/1/21) followed the same patient cohort through 60 months post-op. Comparison data from historical controls up to 60 months post-op is also reported

Displacement or migration of the device at 60 months was be compared to immediate post-op data collected in the IDE study. This was be graded by the radiographic core lab. Migration was considered "present" if changes of \>3mm were noted. The superior index level and inferior index level was assessed separately.

GroupValue95% CI
Simplify Disc0
ACDF: Historical ACDF control data0
Simplify Disc140
ACDF: Historical ACDF control data102

Adverse events — posted to ClinicalTrials.gov

Time frame: Data presented includes adverse events (AEs) collected under both the parent IDE study (G150206) and this Post Approval Study (PAS) for patients who enrolled in this PAS. Data collected from the time of surgery through 24 months was gathered in the IDE (NCT03123549; start date 4/1/17) and data for the same patient cohort from 24 months through 60 months post-op was gather under this PAS (start date 8/1/21). Comparison data from historical controls through 60 months post-op is also reported. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Simplify Disc
Serious: 40/157 (25%)
Deaths: 0/157
ACDF: Historical ACDF Control Data
Serious: 54/134 (40%)
Deaths: 0/134

Serious adverse events (39 terms)

ReactionSystemSimplify DiscACDF: Historical ACDF Cont…
Lumbar radiculopathyMusculoskeletal and connective tissue disorders
Infection (not at surgical site)Infections and infestations
Appendicular arthritisMusculoskeletal and connective tissue disorders
Low back painMusculoskeletal and connective tissue disorders
Nonunion/pseudoarthrosisMusculoskeletal and connective tissue disorders
OtherGeneral disorders
CancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
DysphagiaGastrointestinal disorders
Accidental traumaGeneral disorders
Cervical radiculopathyMusculoskeletal and connective tissue disorders
Psychological illnessPsychiatric disorders
Gastrointestinal complicationsGastrointestinal disorders
Pain (no narcotic given)General disorders
Hematoma or seromaVascular disorders
StrokeVascular disorders
Development of DDD at adjacent levelsMusculoskeletal and connective tissue disorders
Surgery at a location other than the spineSurgical and medical procedures
Difficulty with urinationRenal and urinary disorders
EmbolismVascular disorders
InflammationGeneral disorders
Blood loss (greater than 500 mL)Injury, poisoning and procedural complications
Spinal stenosisMusculoskeletal and connective tissue disorders
Vertebral fractureMusculoskeletal and connective tissue disorders
HypertensionVascular disorders
ThromboembolismVascular disorders
Other adverse events (27 terms — click to expand)

ReactionSystemSimplify DiscACDF: Historical ACDF Cont…
Accidental traumaGeneral disorders
Pain (no narcotic given)General disorders
Appendicular arthritisMusculoskeletal and connective tissue disorders
InflammationGeneral disorders
Lumbar radiculopathyMusculoskeletal and connective tissue disorders
Cervical radiculopathyMusculoskeletal and connective tissue disorders
HeadacheGeneral disorders
Infection (not at surgical site)Infections and infestations
Gastrointestinal complicationsGastrointestinal disorders
Compressive neuropathyNervous system disorders
OtherGeneral disorders
Development of DDD at adjacent levelsMusculoskeletal and connective tissue disorders
Low back pain (narcotic given)Musculoskeletal and connective tissue disorders
Low back pain (no narcotic given)Musculoskeletal and connective tissue disorders
Non-Infectious pulmonary disorderRespiratory, thoracic and mediastinal disorders
Pain (narcotic given)General disorders
Numbness - increased from pre-op or prior visitNervous system disorders
SpasmMusculoskeletal and connective tissue disorders
DysphagiaGastrointestinal disorders
Cardiac eventCardiac disorders
Neck stiffnessMusculoskeletal and connective tissue disorders
Psychological illnessPsychiatric disorders
HypertensionVascular disorders
Dermatitis/Skin allergySkin and subcutaneous tissue disorders
Nonunion/pseudoarthrosisMusculoskeletal and connective tissue disorders
Sleep apneaRespiratory, thoracic and mediastinal disorders
Allergic rhinitisImmune system disorders

Most-reported serious reactions: Lumbar radiculopathy, Infection (not at surgical site), Appendicular arthritis, Low back pain, Nonunion/pseudoarthrosis, Other, Cancer, Dysphagia.

Data from ClinicalTrials.gov NCT04980378 adverse events section.

Sponsor's own description

This study is intended to demonstrate the 5-year long-term safety and efficacy of the Simplify® Cervical Artificial Disc ("Simplify Disc") in subjects enrolled in the non-randomized two-level Simplify Disc Investigational Device Exemption (IDE) study. This study was conducted under IDE G150206

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

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