Cervical Myelopathy for Hip Fracture

Recruiting at 2 trial locations

Overseen By Rowan Flynn, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Indiana University

Disqualifiers: Dementia, Parkinson's, Stroke, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

75 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial focuses on detecting cervical myelopathy, a condition where the spinal cord in the neck becomes compressed, in individuals who have broken their hip from a simple fall. The goal is to identify and treat this neck issue to help prevent future falls and fractures. Participants will undergo a detailed check-up and, if necessary, an MRI scan of the neck (Cervical MRI). The trial seeks individuals who broke their hip from a ground-level fall and are receiving treatment at specific hospitals, excluding those whose falls resulted from conditions like dementia or a stroke. As an unphased trial, this study aims to better understand and address a critical health issue, offering participants the chance to contribute to important medical research.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this screening method is safe for hip fracture patients?

Research has shown that MRI (Magnetic Resonance Imaging) for cervical myelopathy is generally well-tolerated. MRIs are a common and safe imaging method for most people, using magnets and radio waves to create detailed pictures of the spine without radiation exposure.

No negative effects have been directly linked to having an MRI for cervical myelopathy. The procedure is non-invasive, meaning it doesn't involve surgery or entering the body. However, some people might feel uncomfortable due to the small space inside the MRI machine.

Overall, MRIs are widely and safely used in many medical settings, making them a reliable choice for assessing conditions like cervical myelopathy. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about evaluating cervical myelopathy in hip fracture patients using a cervical MRI because it introduces a proactive diagnostic approach. Unlike standard treatments that typically focus solely on the hip fracture itself, this method seeks to uncover any underlying spinal issues that might be contributing to the patient's condition. By using cervical MRI as a diagnostic tool, clinicians can identify cervical myelopathy earlier, potentially leading to more comprehensive care plans and better overall outcomes for patients.

What evidence suggests that using a cervical MRI is effective for identifying cervical myelopathy in hip fracture patients?

Research has shown that many people with hip fractures from falls may have an undiagnosed condition called cervical myelopathy. This condition occurs when the spinal cord in the neck is compressed, affecting movement and strength. Studies suggest that identifying this condition could help prevent further falls and fractures. In this trial, participants will undergo a history and physical exam to check for clinical signs or symptoms of cervical myelopathy. If symptoms are present, standard care includes scheduling a cervical MRI for further evaluation. A cervical MRI can detect the condition early, leading to treatments that improve health outcomes. For instance, surgery for cervical myelopathy has greatly improved patients' mobility. Early detection can thus help prevent additional problems. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for patients admitted to specific hospitals with hip fractures from a ground level fall. It aims to identify undiagnosed cervical myelopathy, which can prevent future falls and fractures.

Inclusion Criteria

I was admitted to a specified hospital for a hip fracture from a fall.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Evaluation

Participants undergo a history and physical exam to evaluate for clinical signs or symptoms of cervical myelopathy

1 week

1 visit (in-person)

Diagnosis

Participants with positive history and physical exam are referred for a cervical MRI to confirm diagnosis

Prior to hospital discharge

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after diagnosis

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Cervical MRI

Trial Overview Patients will undergo a history and physical exam to screen for cervical myelopathy. If needed, an MRI will be offered as part of the screening process.

How Is the Trial Designed?

Group I: Evaluation for Cervical Myelopathy Experimental Treatment 2 Interventions

Hip fracture patients who agree to participate will undergo a history and physical exam to specifically evaluate for clinical signs or symptoms of cervical myelopathy. If the history and physical exam is positive for such symptoms, a cervical MRI will be scheduled as part of standard care to further evaluate for this diagnosis. If the history and physical exam is negative for such symptoms, further clinical evaluation for this condition will not occur.

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11561916/

Outcomes for Degenerative Cervical Myelopathy Following ... Surgical Outcomes. There was a significant improvement in the mean total mJOA score by 1.53 points at 3 months (P < .001), 1.44 points at 6 ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06893406

NCT06893406 | Cervical Myelopathy in Hip Fracture Patients Recent evidence has demonstrated a high rate of undiagnosed cervical myelopathy in patients presenting with hip fractures from a ground level fall.

3. dukespace.lib.duke.edu dukespace.lib.duke.edu/bitstreams/8d5018df-21e5-4c9c-b011-1fe9e1f3c8d3/download

High Prevalence of Cervical Myelopathy among Hip Fracture ... The data seen in this investigation support this and suggest that myelopathy screening may be a valuable part of hip fracture prevention ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8310478/

Clinical outcomes in patients admitted to hospital with ... Patients admitted with a cervical fracture are twice as likely to die within 30 days of injury than those with a hip fracture.

5. nature.com nature.com/articles/s41598-025-20928-4

Assessing the diagnostic accuracy of symptoms and signs ... Degenerative cervical myelopathy (DCM) is a condition caused by compression of the cervical spinal cord, resulting in varying degrees of motor, ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S1529943025001597

Normalizing spinal cord compression measures in ... This study introduced an automatic method for computing normalized measures of cord compressions from MRIs, potentially improving therapeutic decisions in DCM ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11240080/

Radiological Progression of Degenerative Cervical ... Imaging findings such as the level and severity of spinal cord compression may not match the patient's experience of their symptoms over time, ...

8. nature.com nature.com/articles/s41598-021-89848-3

A deep learning model for detection of cervical spinal cord ... We aimed to develop and validate a deep learning model for detection of cervical spinal cord compression in MRI scans. Patients undergoing ...

9. mdpi.com mdpi.com/2076-3425/15/6/557

The Severity on Imaging Myelopathy Score (SIMS) This new multi-parametric MRI-based scoring system represents a consistent means to characterize the degree of severity of degenerative cervical myelopathy.

10. aafp.org aafp.org/pubs/afp/issues/2020/1215/p740.html

Degenerative Cervical Myelopathy: Recognition and ... Since a delay in the diagnosis of degenerative cervical myelopathy can lead to poorer outcomes, evaluation and referral should be done in a ...