K Number
K163481
Device Name
HALF DOME Posterior Lumbar Interbody System
Manufacturer
Date Cleared
2017-05-03

(142 days)

Product Code
Regulation Number
888.3080
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Half Dome Posterior Lumbar Intervertebral body fusion body fusion procedures in skeletally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). Half Dome implants are to be used with autogenous bone graft and supplemental fixation. Patients should have at least six (6) months of non-operative treatment prior to treatment with an intervertebral cage.
Device Description
The Half Dome Posterior Lumbar Interbody devices are implants developed for the substitution of the classical autogenous bone graft blocks They are available in a range of footprints and heights to suit the individual pathology and anatomical conditions of the patient. The implants have a hollow center to allow placement of autogenous bone graft. The Half Dome cages are designed to be used in conjunction with supplemental spinal fixation instrumentation.
More Information

No
The 510(k) summary describes a physical interbody fusion device and does not mention any software, algorithms, or AI/ML capabilities. The performance studies are focused on mechanical properties.

Yes.

The device is an implantable intervertebral body fusion device used to treat degenerative disc disease and is designed to provide structural support and promote bone fusion, which are therapeutic actions.

No

This device is an implant designed for spinal fusion procedures, specifically intervertebral body fusion. Its purpose is to substitute bone graft and provide structural support, not to diagnose a condition.

No

The device description clearly states that the Half Dome Posterior Lumbar Interbody devices are implants, which are physical hardware components. The summary also details non-clinical performance studies related to the mechanical properties of these implants.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description: The Half Dome Posterior Lumbar Interbody device is an implant designed to be surgically placed in the lumbar spine to facilitate bone fusion. It is a physical device used within the body, not to test samples from the body.
  • Intended Use: The intended use clearly describes a surgical procedure for treating degenerative disc disease by implanting the device. This is a therapeutic intervention, not a diagnostic test.

The information provided describes a surgical implant, not a device used for testing biological samples.

N/A

Intended Use / Indications for Use

The Half Dome Posterior Lumbar Intervertebral body fusion body fusion procedures in sketally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). Half Dome implants are to be used with autogenous bone graft and supplemental fixation. Patients should have at least six (6) months of non-operative treatment prior to treatment with an intervertebral cage.

Product codes

MAX

Device Description

The Half Dome Posterior Lumbar Interbody devices are implants developed for the substitution of the classical autogenous bone graft blocks They are available in a range of footprints and heights to suit the individual pathology and anatomical conditions of the patient. The implants have a hollow center to allow placement of autogenous bone graft. The Half Dome cages are designed to be used in conjunction with supplemental spinal fixation instrumentation.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

lumbar spine at one or two contiguous levels from L1-L2 to L5-S1

Indicated Patient Age Range

skeletally mature patients

Intended User / Care Setting

Prescription Use

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

No clinical studies were performed.
Non-clinical tests conducted:

  • Static and dynamic compression per ASTM F2077
  • Subsidence per ASTM F2267
  • Push Out per ASTM F-04.25.02.02 DRAFT
    Results indicate that the Titanium Half Dome implants are equivalent to predicate devices.

Key Metrics

Not Found

Predicate Device(s)

Half Dome Posterior Lumbar Interbody System (K152512)

Reference Device(s)

ALTA Cervical Interbody Spacer (K160154), Next OrthoSurgical InterForm Interbody Cage System (K131082), Titan Spine Endoskeleton TT IBD (K083714), Titan Spine Endoskeleton TO Interbody Fusion Device (K102067)

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other, creating a sense of depth and unity.

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

May 3, 2017

Astura Medical Troy Taylor Manager of Quality and Regulatory Affairs 5670 El Camino Real, Suite B Carlsbad, California 92008

Re: K163481

Trade/Device Name: Half Dome Posterior Lumbar Interbody System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: MAX Dated: April 5, 2017 Received: April 6, 2017

Dear Mr. Taylor:

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 devicerelated 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.

1

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education 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. 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 Industry and Consumer Education 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,

Mark N. Melkerson -S

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

Enclosure

2

Indications for Use

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

510(k) Number (if known)

K163481 Page 1 of 1

Device Name

Half Dome Posterior Lumbar Interbody System

Indications for Use (Describe)

The Half Dome Posterior Lumbar Intervertebral body fusion body fusion procedures in sketally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). Half Dome implants are to be used with autogenous bone graft and supplemental fixation. Patients should have at least six (6) months of non-operative treatment prior to treatment with an intervertebral cage.

X Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995,

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) Summary

Date Prepared12/06/2016
Submitted ByAstura Medical
5670 El Camino Real, Suite B
Carlsbad, CA 92008
Phone: 760-814-8047
ContactTroy Taylor
Email: Troy@asturamedical.com
Trade NameHalf Dome Posterior Lumbar Interbody System
Common NameIntervertebral body fusion device
Classification NameIntervertebral body fusion device - lumbar
ClassII
Product CodeMAX
CFR Section21 CFR section 888.3080
Device PanelOrthopedic
Primary Predicate
DeviceHalf Dome Posterior Lumbar Interbody System (K152512)
Secondary Predicate
DeviceALTA Cervical Interbody Spacer (K160154)
Next OrthoSurgical InterForm Interbody Cage System (K131082)
Titan Spine Endoskeleton TT IBD (K083714)
Titan Spine Endoskeleton TO Interbody Fusion Device (K102067)
Device DescriptionThe Half Dome Posterior Lumbar Interbody devices are implants developed for
the substitution of the classical autogenous bone graft blocks They are
available in a range of footprints and heights to suit the individual pathology
and anatomical conditions of the patient. The implants have a hollow center to
allow placement of autogenous bone graft. The Half Dome cages are designed
to be used in conjunction with supplemental spinal fixation instrumentation.
MaterialsVestakeep®i4R PEEK per ASTM F2026
Tantalum per ASTM F560
Titanium alloy (Ti-6Al-4V ELI) per ASTM F136
Substantial
Equivalence Claimed
to Predicate DevicesThe Titanium Half Dome Posterior Lumbar Interbody System is substantially
equivalent to the predicate devices in terms of intended use, design, materials
used, mechanical safety and performances.
Indications for UseThe Half Dome Posterior Lumbar Interbody System is indicated for
intervertebral body fusion procedures in skeletally mature patients with
degenerative disc disease (DDD) of the lumbar spine at one or two contiguous
levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with
degeneration of the disc confirmed by history and radiographic studies. These
DDD patients may also have up to Grade I spondylolisthesis or retrolisthesis at
the involved level(s). Half Dome implants are to be used with autogenous bone
graft and supplemental fixation. Patients should have at least six (6) months of
non-operative treatment prior to treatment with an intervertebral cage.
Non-clinical Test
SummaryThe following analyses were conducted:
● Static and dynamic compression per ASTM F2077
● Subsidence per ASTM F2267
● Push Out per ASTM F-04.25.02.02 DRAFT
The results of these evaluations indicate that the Titanium Half Dome implants are equivalent to predicate devices.
Clinical Test SummaryNo clinical studies were performed
Conclusions: Non-Clinical and ClinicalAstura Medical considers the Half Dome Posterior Lumbar Interbody System to be equivalent to the predicate devices listed above. This conclusion is based upon the devices' similarities in principles of operation, technology, materials and indications for use.

4