The Plasmapore® XP Spinal Implant System are indicated for spinal fusion procedures at one or two contiguous levels (L2-S1) in skeletally mature patients with degenerative disc disease (DDD). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at involved levels. These patients may have had previous non-fusion surgery at the involved spinal level(s). The Plasmapore® XP Spinal Implant System is intended for use with supplemental spinal fixation systems that have been cleared for use in the lumbrosacral spine (i.e., posterior pedicle screw and rod systems, and anterior screw and rod systems). The Plasmapore® XP Spinal Implants can be used individually or in pairs. The Plasmapore® XP Spinal Implant System is also intended for use with autogenous bone graft.

Patients must have undergone a regiment of non-operative treatment prior to being treated with the device.

Device Description

The Plasmapore® XP Spinal Implant System is an intervertebral body fusion device that is implanted into the vertebral body space to improve stability of the spine while supporting fusion. Components are offered in a variety of shapes and sizes to meet the requirements of the individual patient anatomy. Components are manufactured from PEEK – Optima (per ASTM F2026) with a titanium layer and a vacuum plasma spray coating (Plasmapore® - per ISO 5832-3). The device will have titanium alloy (TiAl6V4) radiographic markers per ISO 5832-3.

AI/ML Overview

The provided document, K132421, describes the 510(k) premarket notification for the Plasmapore® XP Spinal Implant System. This document focuses on demonstrating substantial equivalence to a predicate device through non-clinical performance testing. It does not contain information about clinical studies with human participants, AI algorithms, or related ground truth establishment, expert consensus, or multi-reader multi-case studies.

Therefore, the following information is extracted directly from the provided text, and many of the requested sections related to AI performance, human user studies, and ground truth are not applicable or not present in this type of submission.

Acceptance Criteria and Device Performance

The device's premarket submission is based on demonstrating substantial equivalence to existing predicate devices through a series of non-clinical, laboratory performance tests. The acceptance criteria are implicitly that the Plasmapore® XP Spinal Implant System "meets or exceeds the performance of the predicate devices" for the tested parameters.

Acceptance Criteria (Implicit from Predicate Equivalence)	Reported Device Performance
Performance equivalent or superior to predicate devices (K071983 and K123909)	The results of the non-clinical tests showed that the Plasmapore® XP Spinal Implant System meets or exceeds the performance of the predicate devices.
Specific Performance Tests:
Static torsion per ASTM F2077	Testing performed. Results demonstrated equivalence/superiority.
Static and dynamic axial compression per ASTM F2077	Testing performed. Results demonstrated equivalence/superiority.
Shear resistance evaluation per ASTM F2267	Testing performed. Results demonstrated equivalence/superiority.
Subsidence per ASTM F2267	Testing performed. Results demonstrated equivalence/superiority.
Wear Debris Analysis per ASTM F1877	Testing performed. Results demonstrated equivalence/superiority.
Microstructure of the coating per ASTM F1854	Testing performed. Results demonstrated equivalence/superiority.
Static Tensile Strength per ASTM F1147	Testing performed. Results demonstrated equivalence/superiority.
Static Shear Strength per ASTM F1044	Testing performed. Results demonstrated equivalence/superiority.
Shear Fatigue Test per ASTM F1160	Testing performed. Results demonstrated equivalence/superiority.
Abrasion Resistance per ASTM F1978	Testing performed. Results demonstrated equivalence/superiority.

Study Details

Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):
- This submission describes non-clinical (laboratory) testing of the device, not a human clinical study or AI algorithm test set. Therefore, there is no "test set" of patient data in the context of an AI algorithm or clinical trial. The "samples" would typically refer to physical device specimens tested in a laboratory. The document does not specify the number of device samples used for each test.
- Data Provenance: Not applicable as it refers to non-clinical laboratory testing. The testing was performed by Aesculap, an American company (or its affiliates under the Aesculap brand), suggesting the data originates from their internal testing or third-party labs.
Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience):
- Not applicable. Ground truth in this context is established by standardized laboratory testing methods (ASTM and ISO standards) and the physical properties/performance of the device specimens, rather than human expert interpretation of data.
Adjudication method (e.g. 2+1, 3+1, none) for the test set:
- Not applicable. This pertains to non-clinical laboratory testing.
If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
- Not applicable. This submission concerns a physical medical device (spinal implant), not an AI-assisted diagnostic or interpretative system.
If a standalone (i.e. algorithm only without human-in-the loop performance) was done:
- Not applicable. This submission concerns a physical medical device, not an AI algorithm.
The type of ground truth used (expert consensus, pathology, outcomes data, etc):
- The "ground truth" for this device's performance is derived from standardized physical and mechanical testing protocols (ASTM and ISO standards) applied to device specimens in a laboratory setting. The acceptability is determined by meeting or exceeding the performance thresholds of the predicate devices under these controlled conditions.
The sample size for the training set:
- Not applicable. This is not an AI algorithm. There is no "training set" in this context.
How the ground truth for the training set was established:
- Not applicable. This is not an AI algorithm.

Summary

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K132421

Page 1 of 3

510(k) Premarket Notification System

Plasmapore® XP (Prospace) Spinal Implant (Plasmapore® Coated)

510(k) SUMMARY (as required by 21 CFR 807.92) B.

JAN 2 2 2014

Aesculap® Implant Systems(AIS) – Plasmapore® XP Spinal Implant System

December 18, 2013

COMPANY:	Aesculap®Implant Systems (AIS), LLC.3773 Corporate ParkwayCenter Valley, PA 18034Establishment Registration Number: 3005673311
CONTACT:	Lisa M. Boyle, Sr. Regulatory Affairs Specialist610-984-9274 (phone)610-791-6882 (fax)lisa.boyle@aesculap.com
TRADE NAME:	AIS Plasmapore® XP Spinal Implant System
COMMON NAME:	Intervertebral Fusion Device Device
CLASSIFICATION NAME:	Orthosis, Spinal Intervertebral Fusion
REGULATION NUMBER:	888.3080
PRODUCT CODE:	MAX

Orthopedics

PURPOSE FOR PREMARKET SUBMISSION

The AIS Plasmapore® XP Spinal Implant System described in this submission is for modifications made to the PEEK Prospace implant and for the addition of a Plasmapore® coating to the existing ProSpace PEEK Intervertebral Body Fusion implants cleared under K071983.

INDICATIONS FOR USE

REVIEW PANEL:

When used as an Intervertebral Body Fusion System:

The Plasmapore® XP Spinal Implant System is indicated for spinal fusion procedures at one or two contiguous levels (L2-S1) in skeletally mature patients with degenerative disc disease (DDD). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at involved levels. These patients may have had previous non-fusion spinal surgery at the involved spinal level(s). The Plasmapore® XP Spinal Implant System is intended for use with supplemental spinal fixation systems that have been cleared for use in the lumbrosacral spine (i.e., posterior pedicle screw and rod systems, anterior plate systems, and anterior screw and rod systems). The Plasmapore® oyetems, antenor place of can be used individually or in pairs. The Plasmapore® XP Spinal Implant System is also intended for use with autogenous bone graft.

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510(k) Premarket Notification System

Plasmapore® XP (Prospace) Spinal Implant (Plasmapore® Coated

Patients must have undergone a regimen of at least six (6) months of non-operative treatment prior to being treated with the device.

DEVICE DESCRIPTION

TECHNOLOGICAL CHARACTERISTICS(compared to Predicate(s))

The components of the Plasmapore® XP Spinal Implant System are offered in the same range of shapes and sizes as the predicate device. The material used for the Aesculap® Implant Systems device is the same as that used to manufacture the predicate devices. The only difference between the predicate device and the subject device is the titanium layer and a vacuum plasma spray coating (Plasmapore®).

PERFORMANCE DATA

As recommended by the FDA Guidance for Spinal System 510(k)'s, non-clinical testing was performed to demonstrate that the AIS ProSpace XP implant is substantially equivalent to other predicate devices. The following testing was performed:

Static torsion per ASTM F2077 .
Static and dynamic axial compression per ASTM F2077 ●
Shear resistance evaluation per ASTM F2267 .
Subsidence per ASTM F2267. .
Wear Debris Analysis per ASTM F1877 ●

In addition to FDA's Spine Guidance, Aesculap has also completed non-clinical testing recommended in the "Guidance for Industry on the Testing of Metallic Plasma Sprayed Coatings on Orthopedic Implants to Support Reconsideration of Postmarket Surveillance Requirements." The following tests were performed:

Microstructure of the coating per ASTM F1854 .
Static Tensile Strength per ASTM F1147 .
Static Shear Strength per ASTM F1044 · .
Shear Fatique Test per ASTM F1160 .
Abrasion Resistance per ASTM F1978 .

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510(k) Premarket Notification System

Plasmapore® XP (Prospace) Spinal Implant (Plasmapore® Coated)

The results of these tests showed that the Plasmapore® XP Spinal Implant System meets or exceeds the performance of the predicate devices, and the device is therefore found to be substantially equivalent.

SUBSTANTIAL EQUIVALENCE

AIS believes that the Plasmapore® XP Spinal Implant System is substantially equivalent to the design of the AIS PEEK VBR and Intervertebral Body Fusion Systems (K071983). The Plasmapore® coating has been used and cleared in a number of legally marketed product lines manufactured by Aesculap (hip, knee, and spinal implants) for many years. The most recent Spinal Implant to be cleared with the Plasmapore® coating is the CeSpace XP Intervertebral Body Fusion Device (K123909).

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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized caduceus symbol, which features a staff with a snake winding around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the caduceus symbol.

DEPARTMENT OF HEALTH & HUMAN SERVICES

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

January 22, 2014

Aesculap Implant Systems, Incorporated Ms. Lisa M. Boyle Senior Regulatory Affairs Specialist 3773 Corporate Parkway Center Valley, Pennsylvania 18034

Re: K132421

Trade/Device Name: AIS Plasmapore XP Spinal Implant System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral body fusion device Regulatory Class: Class II Product Code: MAX Dated: December 19, 2013 Received: December 20, 2013

Dear Ms. Boyle:

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 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

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Page 2 - Ms. Lisa M. Boyle

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Lori A. Wiggins

for

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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K 132421

Device Name

Plasmapore® XP Spinal Implant System

Indications for Use (Describe)

Patients must have undergone a regiment of non-operative treatment prior to being treated with the device.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

A CONTRACTION OF THE WARDED A FOR FOR FOR FOR FOR FOR FOR FOR FOR THE OFFICE

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

FORM FDA 3881 (1/14)

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page.

PSC Publishing Services (10)) 443-6740

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Regulation Number and Section

§ 888.3080 Intervertebral body fusion device.

(a)
Identification. An intervertebral body fusion device is an implanted single or multiple component spinal device made from a variety of materials, including titanium and polymers. The device is inserted into the intervertebral body space of the cervical or lumbosacral spine, and is intended for intervertebral body fusion.(b)
Classification. (1) Class II (special controls) for intervertebral body fusion devices that contain bone grafting material. The special control is the FDA guidance document entitled “Class II Special Controls Guidance Document: Intervertebral Body Fusion Device.” See § 888.1(e) for the availability of this guidance document.(2) Class III (premarket approval) for intervertebral body fusion devices that include any therapeutic biologic (e.g., bone morphogenic protein). Intervertebral body fusion devices that contain any therapeutic biologic require premarket approval.
(c)
Date premarket approval application (PMA) or notice of product development protocol (PDP) is required. Devices described in paragraph (b)(2) of this section shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.