K Number
K190071
Device Name
Perla® Posterior Cervico-Thoracic Fixation System
Manufacturer
Date Cleared
2019-02-25

(41 days)

Product Code
Regulation Number
888.3075
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The PERLA® posterior cervico-thoracic fixation system is intended to provide immobilization of spinal segments as an adjunct to following acute and chronic instabilities of the cervical spine (C 1 to C7) and the thoracic spine from Tl-T3: traumatic spinal fractures and/or traumatic dislocations; instability or deformity; failed previous fusions (e.g., pseudarthrosis); tumors involving the cervical spine; and degenerative disease, including intractable radiculopathy and/or myelopathy, neck and/or arm pain of discogenic origin as confirmed by radiographic studies, and degenerative disease of the facets with instability. The PERLA® posterior cervico-thoracic fixation system is also intended to restore the integrity of the spinal column even in the a limited time period in patients with advanced stage tumors involving the cervical spine in whom life expectancy is of insufficient duration to permit achievement of fusion. In order to achieve additional levels of fixation, the PERLA® posterior cervico-thoracic fixation system may be connected to the ROMEO® Posterior Osteosynthesis System with rod connectors. Transition rods may also be used to connect the PERLA® posterior cervico-thoracic fixation system to the ROMEO® Posterior Osteosynthesis System. Refer to the ROMEO® Posterior Osteosynthesis System package insert for a list of the ROMEO® Posterior Osteosynthesis System indications of use.
Device Description
The Spineart Perla® system is a posterior cervico-thoracic fixation system intended to provide stabilization to promote fusion of the cervical spine and the upper thoracic spine. Perla® system consists of a variety of shapes and sizes of rods, hooks, multi-axial screws, set screws, rod connectors and transverse connectors. These connecting components can be rigidly locked to the rod in a variety of configurations to be adapted for the individual case. The multi-axial screws are available with diameters 3.5mm and 4.0 mm with lengths ranging from 08 mm up to 52 mm. The purpose of this Special 510(k) application is to introduce an additional range of multi-axial screw with 4.5 mm diameter and lengths ranging from 08 mm up to 52 mm to the Perla® spinal system.
More Information

No
The 510(k) summary describes a mechanical spinal fixation system and does not mention any AI or ML components or functionalities.

Yes
The device is a posterior cervico-thoracic fixation system intended to provide immobilization and stabilization of spinal segments, which are therapeutic functions.

No
The device is a fixation system used to immobilize spinal segments, not to diagnose a condition.

No

The device description explicitly states it consists of physical components like rods, hooks, screws, and connectors, which are hardware.

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

Here's why:

  • Intended Use: The intended use clearly describes a surgical implant system for stabilizing the spine. This is a therapeutic device, not a diagnostic one.
  • Device Description: The description details physical components like rods, hooks, and screws, which are used in surgical procedures.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (blood, tissue, etc.) or providing diagnostic information about a patient's condition.
  • Performance Studies: The performance studies focus on the mechanical properties and safety of the implant, not on diagnostic accuracy.

IVD devices are used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening. This device does not fit that description.

N/A

Intended Use / Indications for Use

The PERLA® posterior cervico-thoracic fixation system is intended to provide immobilization of spinal segments as an adjunct to following acute and chronic instabilities of the cervical spine (C 1 to C7) and the thoracic spine from Tl-T3: traumatic spinal fractures and/or traumatic dislocations; instability or deformity; failed previous fusions (e.g., pseudarthrosis); tumors involving the cervical spine; and degenerative disease, including intractable radiculopathy and/or myelopathy, neck and/or arm pain of discogenic origin as confirmed by radiographic studies, and degenerative disease of the facets with instability. The PERLA® posterior cervico-thoracic fixation system is also intended to restore the integrity of the spinal column even in the a limited time period in patients with advanced stage tumors involving the cervical spine in whom life expectancy is of insufficient duration to permit achievement of fusion. In order to achieve additional levels of fixation, the PERLA® posterior cervico-thoracic fixation system may be connected to the ROMEO® Posterior Osteosynthesis System with rod connectors. Transition rods may also be used to connect the PERLA® posterior cervico-thoracic fixation system to the ROMEO® Posterior Osteosynthesis System. Refer to the ROMEO® Posterior Osteosynthesis System package insert for a list of the ROMEO® Posterior Osteosynthesis System indications of use.

Product codes

NKG, KWP

Device Description

The Spineart Perla® system is a posterior cervico-thoracic fixation system intended to provide stabilization to promote fusion of the cervical spine and the upper thoracic spine. Perla® system consists of a variety of shapes and sizes of rods, hooks, multi-axial screws, set screws, rod connectors and transverse connectors. These connecting components can be rigidly locked to the rod in a variety of configurations to be adapted for the individual case. The multi-axial screws are available with diameters 3.5mm and 4.0 mm with lengths ranging from 08 mm up to 52 mm. The purpose of this Special 510(k) application is to introduce an additional range of multi-axial screw with 4.5 mm diameter and lengths ranging from 08 mm up to 52 mm to the Perla® spinal system.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

radiographic studies

Anatomical Site

cervical spine (C1 to C7) and the thoracic spine from T1-T3

Indicated Patient Age Range

Not Found

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)

An engineering analysis was performed and determined the new 4.5 mm multi-axial screws do not constitute a new worst-case design in the Perla spinal system. No additional testing has been performed for the Perla® 4.5 mm multi-axial screws.

The following non-clinical tests were conducted on predicate devices:

  • Static Compression Bending, Static Torsion and Dynamic Compression Bending according to ASTM F1717
  • Static flexion-extension testing, Static axial gripping and Static torsion gripping according to ASTM F1798
  • Axial pullout strength and Torque to failure according to ASTM F543
  • Bacterial endotoxin testing as specified in USP standard is used for pyrogenicity testing to achieve the Endotoxin limit of 20 EU / device.

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

Not Found

Predicate Device(s)

K153386

Reference Device(s)

ROMEO® Posterior Osteosynthesis System

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3075 Posterior cervical screw system.

(a)
Identification. Posterior cervical screw systems are comprised of multiple, interconnecting components, made from a variety of materials that allow an implant system to be built from the occiput to the upper thoracic spine to fit the patient's anatomical and physiological requirements, as determined by preoperative cross-sectional imaging. Such a spinal assembly consists of a combination of bone anchors via screws (i.e., occipital screws, cervical lateral mass screws, cervical pedicle screws, C2 pars screws, C2 translaminar screws, C2 transarticular screws), longitudinal members (e.g., plates, rods, including dual diameter rods, plate/rod combinations), transverse or cross connectors, interconnection mechanisms (e.g., rod-to-rod connectors, offset connectors), and closure mechanisms (e.g., set screws, nuts). Posterior cervical screw systems are rigidly fixed devices that do not contain dynamic features, including but not limited to: non-uniform longitudinal elements or features that allow more motion or flexibility compared to rigid systems.Posterior cervical screw systems are intended to provide immobilization and stabilization of spinal segments in patients as an adjunct to fusion for acute and chronic instabilities of the cervical spine and/or craniocervical junction and/or cervicothoracic junction such as: (1) Traumatic spinal fractures and/or traumatic dislocations; (2) deformities; (3) instabilities; (4) failed previous fusions (
e.g., pseudarthrosis); (5) tumors; (6) inflammatory disorders; (7) spinal degeneration, including neck and/or arm pain of discogenic origin as confirmed by imaging studies (radiographs, CT, MRI); (8) degeneration of the facets with instability; and (9) reconstruction following decompression to treat radiculopathy and/or myelopathy. These systems are also intended to restore the integrity of the spinal column even in the absence of fusion for a limited time period in patients with advanced stage tumors involving the cervical spine in whom life expectancy is of insufficient duration to permit achievement of fusion.(b)
Classification. Class II (special controls). The special controls for posterior cervical screw systems are:(1) The design characteristics of the device, including engineering schematics, must ensure that the geometry and material composition are consistent with the intended use.
(2) Nonclinical performance testing must demonstrate the mechanical function and durability of the implant.
(3) Device components must be demonstrated to be biocompatible.
(4) Validation testing must demonstrate the cleanliness and sterility of, or the ability to clean and sterilize, the device components and device-specific instruments.
(5) Labeling must include the following:
(i) A clear description of the technological features of the device including identification of device materials and the principles of device operation;
(ii) Intended use and indications for use including levels of fixation;
(iii) Device specific warnings, precautions, and contraindications that include the following statements:
(A) “Precaution: Preoperative planning prior to implantation of posterior cervical screw systems should include review of cross-sectional imaging studies (
e.g., CT and/or MRI) to evaluate the patient's cervical anatomy including the transverse foramen, neurologic structures, and the course of the vertebral arteries. If any findings would compromise the placement of these screws, other surgical methods should be considered. In addition, use of intraoperative imaging should be considered to guide and/or verify device placement, as necessary.”(B) “Precaution: Use of posterior cervical pedicle screw fixation at the C3 through C6 spinal levels requires careful consideration and planning beyond that required for lateral mass screws placed at these spinal levels, given the proximity of the vertebral arteries and neurologic structures in relation to the cervical pedicles at these levels.”
(iv) Identification of magnetic resonance (MR) compatibility status;
(v) Cleaning and sterilization instructions for devices and instruments that are provided non-sterile to the end user, and;
(vi) Detailed instructions of each surgical step, including device removal.

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath.

February 25, 2019

SPINEART Mr. Franck Pennesi Chief Technical Officer 3 Chemin du Pré Fleuri 1228 Plan Les Ouates Geneva, Switzerland

Re: K190071

Trade/Device Name: Perla® Posterior Cervico-Thoracic Fixation System Regulatory Class: Unclassified Product Code: NKG, KWP Dated: January 11, 2019 Received: January 15, 2019

Dear Mr. Pennesi:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrl/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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 of medical device-related adverse events) (21 CFR 803) for

1

devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Ronald P. Jean -S

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

Enclosure

2

Indications for Use

510(k) Number (if known) K190071

Device Name

Perla® Posterior Cervico-Thoracic Fixation system

Indications for Use (Describe)

The PERLA® posterior cervico-thoracic fixation system is intended to provide immobilization of spinal segments as an adjunct to following acute and chronic instabilities of the cervical spine (C 1 to C7) and the thoracic spine from Tl-T3: traumatic spinal fractures and/or traumatic dislocations; instability or deformity; failed previous fusions (e.g., pseudarthrosis); tumors involving the cervical spine; and degenerative disease, including intractable radiculopathy and/or myelopathy, neck and/or arm pain of discogenic origin as confirmed by radiographic studies, and degenerative disease of the facets with instability. The PERLA® posterior cervico-thoracic fixation system is also intended to restore the integrity of the spinal column even in the a limited time period in patients with advanced stage tumors involving the cervical spine in whom life expectancy is of insufficient duration to permit achievement of fusion. In order to achieve additional levels of fixation, the PERLA® posterior cervico-thoracic fixation system may be connected to the ROMEO® Posterior Osteosynthesis System with rod connectors. Transition rods may also be used to connect the PERLA® posterior cervico-thoracic fixation system to the ROMEO® Posterior Osteosynthesis System. Refer to the ROMEO® Posterior Osteosynthesis System package insert for a list of the ROMEO® Posterior Osteosynthesis System indications of use.

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.

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

Image /page/3/Picture/1 description: The image shows the logo for Spineart. The logo consists of the word "spineart" in a stylized font, with a butterfly graphic above the "art" portion of the word. The word "spine" is in black, while "art" is in a lighter gray color. The butterfly is purple.

SPECIAL 510k DEVICE MODIFICATION PERLA® POSTERIOR CERVICO-THORACIC FIXATION SYSTEM

510(k) SUMMARY

Type of 510k510k SPECIAL – DEVICE MODIFICATION
Reason for submissionExtension of the range of Perla® Posterior Cervico-Thoracic Fixation system
Submitted bySPINEART
3 Chemin du Pré Fleuri
1228 PLAN LES OUATES
GENEVA SWITZERLAND
ContactsFranck PENNESI Chief Technical Officer
Phone: +41 22 570 1200 Fax: +41 22 594 8306
Mail: fpennesi@spineart.com
Regulatory contact: Dr Isabelle DRUBAIX (Idée Consulting) idrubaix@nordnet.fr
Date PreparedFebruary 20, 2019
Common NameOrthosis, Cervical Pedicle Screw Spinal Fixation
Trade NamePerla® Posterior Cervico-Thoracic Fixation system
Product CodeNKG / KWP
ClassUnclassified
Device panelOrthopedic
Legally marketed predicate devicesPrimary predicate: PERLA Posterior Cervico-Thoracic Fixation System (K153386)
manufactured by Spineart
Additional predicate: None
Indications for useThe PERLA® posterior cervico-thoracic fixation system is intended to provide
immobilization and stabilization of spinal segments as an adjunct to fusion for the
following acute and chronic instabilities of the cervical spine (C 1 to C7) and the thoracic
spine from TI-T3: traumatic spinal fractures and/or traumatic dislocations; instability or
deformity; failed previous fusions (e.g., pseudarthrosis); tumors involving the cervical
spine; and degenerative disease, including intractable radiculopathy and/or myelopathy,
neck and/or arm pain of discogenic origin as confirmed by radiographic studies, and
degenerative disease of the facets with instability. The PERLA® posterior cervico-thoracic
fixation system is also intended to restore the integrity of the spinal column even in the
absence of fusion for a limited time period in patients with advanced stage tumors
involving the cervical spine in whom life expectancy is of insufficient duration to permit
achievement of fusion. In order to achieve additional levels of fixation, the PERLA®
posterior cervico-thoracic fixation system may be connected to the ROMEO® Posterior
Osteosynthesis System with rod connectors. Transition rods may also be used to connect
the PERLA® posterior cervico-thoracic fixation system to the ROMEO® Posterior
Osteosynthesis System. Refer to the ROMEO® Posterior Osteosynthesis System package
insert for a list of the ROMEO® Posterior Osteosynthesis System indications of use.
Description of the deviceThe Spineart Perla® system is a posterior cervico-thoracic fixation system intended to
provide stabilization to promote fusion of the cervical spine and the upper thoracic spine.
Perla® system consists of a variety of shapes and sizes of rods, hooks, multi-axial screws,
set screws, rod connectors and transverse connectors. These connecting components
can be rigidly locked to the rod in a variety of configurations to be adapted for the
individual case.
The multi-axial screws are available with diameters 3.5mm and 4.0 mm with lengths
ranging from 08 mm up to 52 mm. The purpose of this Special 510(k) application is to
introduce an additional range of multi-axial screw with 4.5 mm diameter and lengths
ranging from 08 mm up to 52 mm to the Perla® spinal system.
Technological
characteristics compared
to the predicate devicesThe unique aspect of the new 4.5 mm multi-axial screws which differs from the existing
Perla® multi-axial screws is the diameter of the bone screw that is enlarged to diameter
4.5 mm. All other design features are strictly the same as for existing Perla® multi-axial
screws. Compared with previously cleared predicate multi-axial screws, the subject
multi-axial screws with 4.5 mm in diameter are made of the same material (Titanium
alloy Ti6Al4V ELI conforming to ASTM F136), available in the same lengths ranging from
08 mm up to 52 mm, present the same design and polyaxiality of 60° and use the same
set screw. Both previously cleared and new multi-axial screws are delivered sterile
(gamma sterilization) and supplied with the same dedicated surgical instruments
(reusable – provided non-sterile).
The following non-clinical tests were conducted on predicate devices:
  • Static Compression Bending, Static Torsion and Dynamic Compression Bending
    according to ASTM F1717
  • Static flexion-extension testing, Static axial gripping and Static torsion gripping
    according to ASTM F1798
  • Axial pullout strength and Torque to failure according to ASTM F543
  • Bacterial endotoxin testing as specified in USP standard is used for pyrogenicity testing
    to achieve the Endotoxin limit of 20 EU / device. |
    | Discussion of Testing | An engineering analysis was performed and determined the new 4.5 mm multi-axial
    screws do not constitute a new worst-case design in the Perla spinal system. No
    additional testing has been performed for the Perla® 4.5 mm multi-axial screws. |
    | Conclusion | Based on the design features, technological characteristics, feature comparisons, and
    indications for use, the Perla® 4.5 mm multi-axial screws have demonstrated substantial
    equivalence to the identified predicate devices. |

4