K Number
K110692
Date Cleared
2011-05-12

(62 days)

Product Code
Regulation Number
888.3070
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Streamline TL Spinal System components are non-cervical spinal fixation devices intended as an adjunct to fusion for use as a pedicle screw (T1-S2), sacral/iliac screw fixation or as an anterolateral fixation system (T8-L5). Pedicle screw fixation is limited to skeletally mature patients. These devices are indicated for all of the following indications: degenerative disc disease (defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies), spondylolisthesis, trauma (i.e. fracture or dislocation), deformities or curvatures (i.e. scoliosis, kyphosis, and/or lordosis, Scheuermann's Disease), tumor, stenosis, pseudoarthosis, and failed previous fusion.

Device Description

The Streamline TL Spinal System consists of a variety of rods, pedicle screws, connectors, set screws and other connection components used to build a spinal construct. Cross-links available for use with the Streamline TL system include the Quantum X-Link and the SpineWorks FixxSure Crosslink. The implant components can be rigidly locked into a variety of configurations, with each construct being tailor-made for the individual case. Instrumentation is also available to facilitate implant of device components. The purpose of this submission is to include the FixxSure Cross Link to the Streamline TL System. The Cross Link is designed to provide added fixation to the spinal construct and is available in fixed (23-28mm) and variable lengths (28-66mm).

AI/ML Overview

The provided text describes a 510(k) premarket notification for the Streamline TL Spinal System. This is a medical device for spinal fixation, and the submission is focused on adding a new component, the FixxSure Crosslink, to the existing system. The document outlines the device's description, intended use, materials, and performance data used to demonstrate substantial equivalence to a predicate device.

Here's an analysis of the provided information regarding acceptance criteria and the supporting study:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Implied)Reported Device Performance
Functioning as intended"functioned as intended"
Performance substantially equivalent to predicate system"performed in a manner substantially equivalent to that of the predicate system"

Note: The document does not explicitly state numerical acceptance criteria (e.g., "must withstand X N of force"). Instead, the acceptance is based on demonstrating that the modified device (Streamline TL with FixxSure Crosslink) performs comparably to the previously accepted predicate device (Streamline TL without the new crosslink, and the predicate FixxSure Crosslink). This is a common approach for 510(k) submissions, where substantial equivalence rather than absolute performance metrics is the primary goal.

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size for Test Set: Not explicitly stated. The document mentions "testing was presented to characterize the performance of the Streamline TL construct with the additional FixxSure Crosslink," implying a series of tests, but not the number of units or repetitions used for each test.
  • Data Provenance: The study described is a mechanical performance study (ASTM F1717) conducted to characterize the device's performance. It is a prospective study as it involves testing a newly configured device. The country of origin of the data is not specified, but given the sponsor is in Marquette, MI, USA, and the FDA is reviewing it, it's likely the testing was conducted in the USA or by a lab adhering to international standards.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

This information is not applicable to this type of study. The ground truth for mechanical performance studies like this is objective, measurable physical properties (e.g., force, displacement, cycles to failure) determined by standardized test methods (ASTM F1717). There is no human interpretation or expert consensus involved in establishing the "ground truth" for the device's mechanical strength.

4. Adjudication Method for the Test Set

This information is not applicable as there is no human adjudication for mechanical testing data. The results are quantitative and directly measured.

5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study Was Done

No, a Multi Reader Multi Case (MRMC) comparative effectiveness study was not done. MRMC studies are typically used to assess the impact of a diagnostic or assistive technology on human reader performance, often in imaging. This submission deals with the mechanical performance of a spinal implant, which does not involve human readers in an interpretive capacity.

6. If a Standalone (i.e. algorithm only without human-in-the loop performance) Was Done

Yes, a standalone performance study was done. The performance data presented consists of mechanical testing (ASTM F1717 dynamic compression bending, static compression bending, and static torsion testing) to characterize the performance of the spinal construct. This is a "standalone" assessment of the device's physical properties without human intervention or interpretation for its primary function.

7. The Type of Ground Truth Used

The ground truth used is objective physical measurements obtained through standardized mechanical testing (ASTM F1717). This includes measurements of dynamic compression bending, static compression bending, and static torsion. The "truth" is whether the device withstands certain forces and cycles per defined standards.

8. The Sample Size for the Training Set

This information is not applicable. This submission describes mechanical testing of a medical device, not a machine learning algorithm. Therefore, there is no "training set" in the context of AI or data-driven models.

9. How the Ground Truth for the Training Set Was Established

This information is not applicable as there is no training set for mechanical performance testing.

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长110692

MAY 1 2 2011

510(k) Summary

Sponsor:Pioneer Surgical Technology, Inc.375 River Park CircleMarquette, MI 49855(906) 225-5602Contact: Emily M. DownsDate prepared: April 15, 2011
Device Name:Streamline TL Spinal System
Classification Name:888.3060, Spondylolisthesis Spinal Fixation Device System and 888.3070 Pedicle Screw SpinalSystem, Class III
Product Codes:NKB, KWQ, MNH, MNI, Panel Code 87
Predicate Device:K093692 - Streamline TL Spinal System (SE date - August 11, 2010)K081331 - SpineWorks FixxSure Cross Link (SE date - July 23, 2008)
Description:The Streamline TL Spinal System consists of a variety of rods, pedicle screws, connectors, setscrews and other connection components used to build a spinal construct. Cross-links available foruse with the Streamline TL system include the Quantum X-Link and the SpineWorks FixxSureCrosslink. The implant components can be rigidly locked into a variety of configurations, witheach construct being tailor-made for the individual case. Instrumentation is also available tofacilitate implant of device components.
The purpose of this submission is to include the FixxSure Cross Link to the Streamline TL System.The Cross Link is designed to provide added fixation to the spinal construct and is available infixed (23-28mm) and variable lengths (28-66mm).
Intended Use:The Streamline TL Spinal System components are non-cervical spinal fixation devices intended asan adjunct to fusion for use as a pedicle screw (T1-S2), sacral/iliac screw fixation or as ananterolateral fixation system (T8-L5). Pedicle screw fixation is limited to skeletally maturepatients. These devices are indicated for all of the following indications: degenerative disc disease(defined as discogenic back pain with degeneration of the disc confirmed by history andradiographic studies), spondylolisthesis, trauma (i.e. fracture or dislocation), deformities orcurvatures (i.e. scoliosis, kyphosis, and/or lordosis, Scheuermann's Disease), tumor, stenosis,pseudoarthosis, and failed previous fusion.
Material:Screws, Set Screws, and Connecting components are comprised of Titanium Alloy per ASTM F136.Rods are comprised of Titanium Alloy per ASTM F136 or Cobalt Chromium Molybdenum Alloyper ASTM F1537.
Performance Data:ASTM F1717 dynamic compression bending, static compression bending and static torsion testingwas presented to characterize the performance of the Streamline TL construct with the additionalFixxSure Crosslink.
The test results demonstrate that the addition of the FixxSure Crosslink to the Streamline TL systemfunctioned as intended and performed in a manner substantially equivalent to that of the predicatesystem.
Performance and SEDetermination:Comparisons of device performance data, materials, indications and design/function to predicatedevices were provided in making a determination of substantial equivalence.

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its body and legs. The eagle is positioned within a circle that contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the circumference.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room-WO66-G609 Silver Spring, MD 20993-0002

MAY 1 2 2011

Pioneer Surgical Technology, Inc. % Ms. Emily M. Downs 375 River Park Circle Marquette, Michigan 49855

Re: K110692

Trade/Device Name: Streamline TL Spinal System Regulation Number: 21 CFR 888.3070 Regulation Name: Pedicle screw spinal system Regulatory Class: Class III Product Code: NKB, MNH, MNI, KWO Dated: April 15, 2011 Received: April 18, 2011

Dear Ms. Downs:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you; however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must

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Page 2 - Ms. Emily M. Downs

or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHQffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

http://www.fda.gov/MedicalDevices/ResourcestorYourIndustry/default.htm.

Sincerely yours.

Aly B. R. for

Mark N. Melkerson Director Division of Surgical, Orthopedic And Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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2.0 Indications for Use Statement

K110692 510(k) Number (if known):

Device Name: Streamline TL Spinal System

Indications for Use: The Streamline TL Spinal System components are non-cervical spinal fixation devices intended as an adjunct to fusion for use as a pedicle screw (T1-S2), sacral/iliac screw fixation or as an anterolateral fixation system (T8-L5). Pedicle screw fixation is limited to skeletally mature patients. These devices are indicated for all of the following indications: degenerative disc disease (defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies), spondylolisthesis, trauma (i.e. fracture or dislocation), deformities or curvatures (i.e. scoliosis, kyphosis, and/or lordosis, Scheuermann's Disease), tumor, stenosis, pseudoarthosis, and failed previous fusion.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109)

OR

Over-the-Counter Use
------------------------

(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K110692

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§ 888.3070 Thoracolumbosacral pedicle screw system.

(a)
Identification. (1) Rigid pedicle screw systems are comprised of multiple components, made from a variety of materials that allow the surgeon to build an implant system to fit the patient's anatomical and physiological requirements. Such a spinal implant assembly consists of a combination of screws, longitudinal members (e.g., plates, rods including dual diameter rods, plate/rod combinations), transverse or cross connectors, and interconnection mechanisms (e.g., rod-to-rod connectors, offset connectors).(2) Semi-rigid systems are defined as systems that contain one or more of the following features (including but not limited to): Non-uniform longitudinal elements, or features that allow more motion or flexibility compared to rigid systems.
(b)
Classification. (1) Class II (special controls), when intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar, and sacral spine: severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra; degenerative spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply with the following special controls:(i) Compliance with material standards;
(ii) Compliance with mechanical testing standards;
(iii) Compliance with biocompatibility standards; and
(iv) Labeling that contains these two statements in addition to other appropriate labeling information:
“Warning: The safety and effectiveness of pedicle screw spinal systems have been established only for spinal conditions with significant mechanical instability or deformity requiring fusion with instrumentation. These conditions are significant mechanical instability or deformity of the thoracic, lumbar, and sacral spine secondary to severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra, degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and failed previous fusion (pseudarthrosis). The safety and effectiveness of these devices for any other conditions are unknown.”
“Precaution: The implantation of pedicle screw spinal systems should be performed only by experienced spinal surgeons with specific training in the use of this pedicle screw spinal system because this is a technically demanding procedure presenting a risk of serious injury to the patient.”
(2) Class II (special controls), when a rigid pedicle screw system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in the treatment of degenerative disc disease and spondylolisthesis other than either severe spondylolisthesis (grades 3 and 4) at L5-S1 or degenerative spondylolisthesis with objective evidence of neurologic impairment. These pedicle screw systems must comply with the following special controls:
(i) The design characteristics of the device, including engineering schematics, must ensure that the geometry and material composition are consistent with the intended use.
(ii) Non-clinical performance testing must demonstrate the mechanical function and durability of the implant.
(iii) Device components must be demonstrated to be biocompatible.
(iv) Validation testing must demonstrate the cleanliness and sterility of, or the ability to clean and sterilize, the device components and device-specific instruments.
(v) Labeling must include the following:
(A) A clear description of the technological features of the device including identification of device materials and the principles of device operation;
(B) Intended use and indications for use, including levels of fixation;
(C) Identification of magnetic resonance (MR) compatibility status;
(D) Cleaning and sterilization instructions for devices and instruments that are provided non-sterile to the end user; and
(E) Detailed instructions of each surgical step, including device removal.
(3) Class II (special controls), when a semi-rigid system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion for any indication. In addition to complying with the special controls in paragraphs (b)(2)(i) through (v) of this section, these pedicle screw systems must comply with the following special controls:
(i) Demonstration that clinical performance characteristics of the device support the intended use of the product, including assessment of fusion compared to a clinically acceptable fusion rate.
(ii) Semi-rigid systems marketed prior to the effective date of this reclassification must submit an amendment to their previously cleared premarket notification (510(k)) demonstrating compliance with the special controls in paragraphs (b)(2)(i) through (v) and paragraph (b)(3)(i) of this section.