K Number
K171468
Device Name
FUSE Spinal System
Date Cleared
2017-06-13

(26 days)

Product Code
Regulation Number
888.3080
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The FUSE Cage is indicated for interbody fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two contiguous levels from L2 to S1. These DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at the involved levels. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should be skeletally mature and have had six months of non-operative treatment. These implants may be implanted via an open or a minimally invasive posterior approach. These implants are to be used with autogenous bone graft. These devices are intended to be used with supplemental fixation instrumentation, which has been cleared by the FDA for use in the lumbar spine.
Device Description
The FUSE™ Cage is a titanium interbody cage of various widths and heights, which can be inserted between two lumbar or lumbosacral vertebral bodies to give support and correction during lumbar interbody fusion surgeries. The hollow geometry of the implants allows them to be packed with autogenous bone graft. The implants may be implanted via a posterior or transforaminal approach and the procedure may be open or minimally invasive. The implants can be implanted unilaterally. FUSE™ implants consist of pure titanium according to the standard ISO 5832-2 or ASTM F67. It is not allowed to use FUSE™ cages in direct connection with components of other manufacturers. FUSE™ cages are for single use only.
More Information

Not Found

No
The summary describes a physical interbody cage made of titanium for spinal fusion surgery. There is no mention of software, algorithms, image processing, or any terms related to AI or ML. The performance studies focus on biocompatibility and mechanical strength, not algorithmic performance.

Yes
The FUSE Cage is a medical implant explicitly designed to treat degenerative disc disease by facilitating interbody fusion, which directly addresses a disease state in the human body.

No

This device is a surgical implant (interbody cage) used for spinal fusion, not for diagnosing medical conditions. It is used in treatment after a diagnosis of degenerative disc disease has already been made.

No

The device description clearly states the device is a titanium interbody cage, which is a physical implant, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • FUSE Cage Function: The FUSE Cage is a surgical implant designed to be placed within the body (specifically, between vertebral bodies) to provide structural support during spinal fusion. It does not analyze biological samples.
  • Intended Use: The intended use clearly describes a surgical procedure for treating degenerative disc disease, not a diagnostic test.
  • Device Description: The description focuses on the physical characteristics and material of the implant, not on any analytical or diagnostic capabilities.

Therefore, the FUSE Cage falls under the category of a surgical implant or medical device, not an in vitro diagnostic.

N/A

Intended Use / Indications for Use

The FUSE Cage is indicated for interbody fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two contiguous levels from L2 to S1. These DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at the involved levels. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should be skeletally mature and have had six months of non-operative treatment. These implants may be implanted via an open or a minimally invasive posterior approach. These implants are to be used with autogenous bone graft. These devices are intended to be used with supplemental fixation instrumentation, which has been cleared by the FDA for use in the lumbar spine.

Product codes (comma separated list FDA assigned to the subject device)

MAX

Device Description

The FUSE™ Cage is a titanium interbody cage of various widths and heights, which can be inserted between two lumbar or lumbosacral vertebral bodies to give support and correction during lumbar interbody fusion surgeries. The hollow geometry of the implants allows them to be packed with autogenous bone graft. The implants may be implanted via a posterior or transforaminal approach and the procedure may be open or minimally invasive. The implants can be implanted unilaterally. FUSE™ implants consist of pure titanium according to the standard ISO 5832-2 or ASTM F67. It is not allowed to use FUSE™ cages in direct connection with components of other manufacturers. FUSE™ cages are for single use only.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

L2 to S1 (lumbar or lumbosacral vertebral bodies)

Indicated Patient Age Range

skeletally mature

Intended User / Care Setting

Not Found

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Biocompatibility: Identical to the primary predicate devices the implants in the subject FUSE™ Spinal System are provided in sterile form and are made using commercially pure titanium. The non-sterile instruments are manufactured using stainless steel and are identical to the materials used in the instruments cleared under the primary predicate. The materials used in the subject FUSE™ Spinal System implants and instruments have a long clinical history of safe and effective use in similar commercially available medical devices. Therefore, no additional biocompatibility testing is required.
Mechanical Testing: The predicate Fuse Cage K121288 are 24.5mm in length whereas the subject FUSE™ Spinal System implants are 28mm and 31.5mm in length maintaining the same width and height as the predicate. The ASTM F2077 "Test Methods for Intervertebral Body Fusion Devices," defines a worst case intervertebral body fusion device with the smallest footprint and tallest height. Since we are not reducing the footprint it does not introduce a worst case. The mechanical strength and the expulsion resistance have been documented in a confirmatory engineering rationale.
Non-Pyrogenicity Endotoxin Testing: The bacterial endotoxin test, also known as Limulus amebocyte lysate (LAL) test, was performed utilizing worst case subject implants to verify that the subject implants meet the 20 endotoxin units (EU)/device pyrogen limit specification. Testing was successfully performed and it was confirmed that the subject implants meet the 20 EU/device testing limit for general medical devices that are implanted as outlined in ANSI/AAMI ST72, Bacterial endotoxins - Test methods, routine monitoring, and alternatives to batch testing and USP , Medical Devices – Bacterial Endotoxin and Pyrogen Tests.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K121288, K120368

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

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.

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

Medtronic Sofamor Danek Mr. Ankit Shah Sr. Regulatory Affairs Specialist 1800 Pyramid Place Memphis, Tennessee 38125

June 13, 2017

Re: K171468

Trade/Device Name: FUSE™ Spinal System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: MAX Dated: May 17, 2017 Received: May 18, 2017

Dear Mr. Shah:

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-

Image /page/0/Picture/11 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal features the department's name in a circular arrangement around the perimeter. In the center is a stylized caduceus-like symbol, consisting of three intertwined figures resembling human profiles, which are meant to represent health and well-being.

1

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 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

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| DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration | | Form Approved: OMB No. 0910-0120
Expiration Date: January 31, 2017
See PRA Statement below. |
|-------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------|
| Indications for Use | | |
| 510(k) Number ( if known ) | K171468 | Page 1 of 1 |
| Device Name | K171468
FUSET™ Spinal System | |
| Indications for Use (Describe) | The FUSE Cage is indicated for interbody fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two contiguous levels from L2 to S1. These DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at the involved levels. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should be skeletally mature and have had six months of non-operative treatment. These implants may be implanted via an open or a minimally invasive posterior approach. These implants are to be used with autogenous bone graft. These devices are intended to be used with supplemental fixation instrumentation, which has been cleared by the FDA for use in the lumbar spine. | |
| 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) |

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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FUSE™ Spinal System 510(k) Summary May 2017

I. Submitter:Medtronic Sofamor Danek USA, Inc
1800 Pyramid Place
Memphis, Tennessee 38132
Contact:Ankit K. Shah
Sr. Regulatory Affairs Specialist
Telephone: (901) 344-1272
Fax: (901) 346-9738
Date PreparedMay 17, 2017
II. Device
Proprietary Trade NameFUSE™ Spinal System
Common NameIntervertebral Body Fusion Device
Classification NamesIntervertebral Fusion with Bone Graft,
Lumbar
ClassificationClass II (Implants and Instruments)
Product CodeMAX (21 CFR 888.3080)
PredicatesFUSE Spinal System K121288,
S.E. 06/29/2012 (Primary Predicate)
Capstone Control™ Spinal System
K120368, S.E. 04/09/2012, (Additional
Predicate)

III. PRODUCT DESCRIPTION:

The FUSE™ Cage is a titanium interbody cage of various widths and heights, which can be inserted between two lumbar or lumbosacral vertebral bodies to give support and correction during lumbar interbody fusion surgeries. The hollow geometry of the implants allows them to be packed with autogenous bone graft. The implants may be

4

implanted via a posterior or transforaminal approach and the procedure may be open or minimally invasive. The implants can be implanted unilaterally. FUSE™ implants consist of pure titanium according to the standard ISO 5832-2 or ASTM F67. It is not allowed to use FUSE™ cages in direct connection with components of other manufacturers. FUSE™ cages are for single use only.

IV. INDICATIONS FOR USE:

The FUSE Cage is indicated for interbody fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two contiguous levels from L2 to S1. These DDD patients may also have up to Grade 1 Spondylolisthesis or retrolisthesis at the involved levels. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should be skeletally mature and have had six months of non-operative treatment. These implants may be implanted via an open or a minimally invasive posterior approach. These implants are to be used with autogenous bone graft. These devices are intended to be used with supplemental fixation instrumentation, which has been cleared by the FDA for use in the lumbar spine.

V. Comparison of Technological Characteristics

The subject FUSE™ Spinal System has the same indications, intended use, fundamental scientific technology and material as the previously FDA cleared predicate 1 (primary predicate) Fuse Cage (K121288, S.E. 06/29/2012) and Capstone Control™ Spinal System K120368, S.E. 04/09/2012.

VI. Performance Data

Biocompatibility

Identical to the primary predicate devices the implants in the subject FUSE™ Spinal System are provided in sterile form and are made using commercially pure titanium. The non-sterile instruments are manufactured using stainless steel and are identical to the materials used in the instruments cleared under the primary predicate. The materials used in the subject FUSE™ Spinal System implants and instruments have a long clinical

5

history of safe and effective use in similar commercially available medical devices. Therefore, no additional biocompatibility testing is required.

Mechanical Testing

The predicate Fuse Cage K121288 are 24.5mm in length whereas the subject FUSE™ Spinal System implants are 28mm and 31.5mm in length maintaining the same width and height as the predicate. The ASTM F2077 "Test Methods for Intervertebral Body Fusion Devices," defines a worst case intervertebral body fusion device with the smallest footprint and tallest height. Since we are not reducing the footprint it does not introduce a worst case. The mechanical strength and the expulsion resistance have been documented in a confirmatory engineering rationale.

Medtronic believes that the subject implants do not introduce a new worst case scenario and are substantially equivalent to the predicate device.

Non-Pyrogenicity Endotoxin Testing

The bacterial endotoxin test, also known as Limulus amebocyte lysate (LAL) test, was performed utilizing worst case subject implants to verify that the subject implants meet the 20 endotoxin units (EU)/device pyrogen limit specification. Testing was successfully performed and it was confirmed that the subject implants meet the 20 EU/device testing limit for general medical devices that are implanted as outlined in ANSI/AAMI ST72, Bacterial endotoxins - Test methods, routine monitoring, and alternatives to batch testing and USP , Medical Devices – Bacterial Endotoxin and Pyrogen Tests.

VII. Conclusion:

An engineering rationale and risk analysis has been completed for the change. Based on the engineering rationale, risk analysis and additional supporting documentation provided in this premarket notification, Medtronic believes the subject system demonstrates substantial equivalence to listed predicate devices.