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Segmental Plating System (SPS)

The Segmental Plating System (SPS) is intended for anterior screw fixation to the cervical spine (C2-T1) for the following indications: degenerative disc disease (as defined by neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies), trauma (including fractures), tumors, deformity (kyphosis or scoliosis), pseudarthrosis, failed previous fusions, spondylolisthesis, and spinal stenosis.

IdentiTi SPS Interbody System

The IdentiTi SPS Interbody System is an anterior cervical interbody fusion system intended for spinal fusion procedures in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, myelopathy, and/or pain at multiple contiguous levels from C2-T1. The IdentiTi SPS Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft, allograft comprised of cortical, cancellous, and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

IdentiTi NanoTec SPS Interbody System

The IdentiTi SPS Interbody System with advanced NanoTec surface treatment is an anterior cervical interbody fusion system intended for spinal fusion procedures in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, and/or pain at multiple contiguous levels from C2-T1. The IdentiTi NanoTec SPS Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft, allograft comprised of cortical, cancellous, and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

Transcend SPS Interbody System

The Transcend SPS Interbody System is an anterior cervical interbody fusion system intended for use in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, and/ or pain at multiple contiguous levels from C2-T1. The Transcend SPS Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft comprised of cortical, cancellous and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

Transcend NanoTec SPS Interbody System

The Transcend SPS PEEK Interbody System with advanced NanoTec surface treatment is an anterior cervical interbody fusion system intended for use in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs. CT, MRI), that results in radiculopathy, and/or pain at multiple contiguous levels from C2-T1. The Transcend NanoTec SPS Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft, allograft comprised of cortical, cancellous and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The Segmental Plating System (SPS) is intended for anterior fixation to the cervical spine. The Segmental Plating System (SPS) consists of a variety of sizes of 2 - 4 holes plates and 3.5 mm and 4.0 mm screws that are manufactured from titanium alloy conforming to ASTM F136 and are offered non-sterile. The plate includes a screw anti-backout mechanism. The system will offer instrumentation for the delivery of the plate and screw construct. The instruments in this system are intended for use in surgical procedures. The plate system implants are provided non-sterile to be steam sterilized by the end user.

The IdentiTi and Transcend SPS Interbody Systems are cervical intervertebral body fusion systems designed to be inserted through anterior surgical approaches. The interbody spacers are manufactured from PEEK (polyetheretherketone) Optima LT1 per ASTM F2026, tantalum per ASTM F560, commercially pure titanium (CP Ti Grade 2) per ASTM F67, and an optional hydroxyapatite nano (HAMM) surface treatment. The subject system implants consist of various lengths, widths, heights and lordotic options to accommodate individual patient anatomy. To mitigate risk of expulsion, the interbody endplates feature teeth. All interbody spacers feature an internal graft aperture for placement of graft material to promote fusion through the cage. Additionally, the IdentiTi implants are offered with a microstructure due to the layering of material that forms the porous architecture. This porous geometry extends to the superior and inferior surfaces of the device for implant fixation. The subject IdentiTi and Transcend NanoTec SPS Interbody Systems interbody implant surfaces have been treated with a 20-40 nanometer thin hydroxyapatite (HA) surface treatment. The surface treatment presents a nano-scale topography on the entirety of the implant surface. in addition to macro-/micro-scale topography existing from prior to HA man treatment. The interbody spacers are provided individually packaged and sterile.

The provided text is a 510(k) summary for a medical device (Alphatec Spine Inc.'s Segmental Plating System and Interbody Systems). It discusses regulatory clearance based on substantial equivalence to predicate devices, outlines the device's description, indications for use, and a technological comparison. It also lists performance data from non-clinical testing.

However, the provided text does not contain information about acceptance criteria for an AI/ML medical device, nor does it describe a study involving a test set, ground truth determination, expert consensus, or human-in-the-loop performance evaluation. The document primarily focuses on the mechanical and material aspects of spinal implants and their equivalence to existing devices, with performance data relating to mechanical testing standards (e.g., ASTM F2077, F2267, F1717).

Therefore, I cannot fulfill the request to describe the acceptance criteria and the study that proves the device meets them based on the provided text, as this information is not present. The device in question is a physical implant, not an AI/ML-based diagnostic or therapeutic device.

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The IdentiTi Cervical Porous Ti Interbody System is an anterior cervical interbody fusion system intended for spinal fusion procedures in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, and/or pain at multiple contiguous levels from C2-T1. The IdentiTi Cervical Porous Ti Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft comprised of cortical, cancellous, and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The IdentiTi Cervical Interbody System with advanced NanoTec surface treatment is an anterior cervical interbody fusion system intended for spinal fusion procedures in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, myelopathy, and/ or pain at multiple contiguous levels from C2-T1. The IdentiTi NanoTec Cervical Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft comprised of cortical, cancellous, and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The Transcend Cervical PEEK Interbody System is an anterior cervical interbody fusion system intended for use in skeletally mature patients with cervical disc degeneration and/or cervical instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, and/or pain at multiple contiguous levels from C2-T1. The Transcend Cervical PEEK Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft, allograft comprised of cortical, cancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The Transcend Cervical PEEK Interbody System with advanced NanoTec surface treatment is an anterior cervical interbody fusion system intended for use in skeletally mature patients with cervical disc degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, myelopathy, and/ or pain at multiple contiguous levels from C2-T1. The Transcend NanoTec Cervical Interbody System is intended for use with supplemental fixation systems. The system is designed for use with autograft comprised of cortical, cancellous and/or corticocancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The IdentiTi Cervical Standalone Interbody System is a stand-alone anterior cervical interbody fusion system intended for use in skeletally mature patients for the treatment of cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radiculopathy, and/or pain at multiple contiguous levels from C2-T1. The IdentiTi Cervical Standalone Interbody System is intended to be used with autograft, allograft comprised of cortical, cancellous, and/or cortico-cancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The IdentiTi Cervical Standalone Interbody System with advanced NanoTec surface treatment is a stand-alone anterior cervical interbody fusion system intended for use in skeletally mature patients for the treatment of cervical degeneration and/or cervical spinal instability, as confirmed by imaging studies (radiographs, CT, MRI), that results in radioulopathy, myelopathy, and/or pain at multiple contiguous levels from C2-T1. The IdentiTi NanoTec Cervical Standalone Interbody System is intended to be used with autograft, allograft comprised of cortical, cancellous, and/or cortico-cancellous bone graft, demineralized allograft with bone marrow aspirate, or a combination thereof.

The IdentiTi and Transcend Interbody Systems are cervical intervertebral body fusion systems designed to be inserted through anterior surgical approaches. The interbody spacers are manufactured from PEEK (polyetheretherketone) Optima LT1 per ASTM F2026, tantalum per ASTM F560, titanium alloy (Ti-6A1-4V ELI), and commercially pure titanium (CPTi Grade 2) per ASTM F67. The interbody spacers are available in the following material options: (1) PEEK (polyetheretherketone) with tantalum and titanium alloy markers, or (2) commercially pure porous titanium (PTi), or (3) a combination of commercially pure porous titanium (CPTi Grade 2) per ASTM F67 and titanium alloy (Ti-6Al-4V ELI) per ASTM F136.

The subject IdentiTi and Transcend Interbody Systems implants consist of various lengths, widths, heights and lordotic options to accommodate individual patient anatomy. To mitigate risk of expulsion, the interbody endplates feature teeth. All interbody spacers feature an internal graft aperture for placement of graft material to promote fusion through the cage. Additionally, the IdentiTi implants are offered with a microstructure due to the layering of material that forms the porous architecture. This porous geometry extends to the superior and inferior surfaces of the device for implant fixation.

The IdentiTi and Transcend NanoTec Interbody Systems implant surfaces have been treated with a 20-40 nanometer thin hydroxyapatite (HA) surface treatment. The surface treatment presents nano-scale topography on the entirety of the implant surface, in addition to macro-/micro-scale topography existing from prior to treatment.

The document provided is a 510(k) Pre-Market Notification for the Alphatec Spine Inc. IdentiTi™ and Transcend™ Interbody Systems. This submission aims to demonstrate substantial equivalence to legally marketed predicate devices, rather than proving that a device meets specific acceptance criteria through a study with performance metrics.

The document does not contain the kind of detailed information about acceptance criteria and study results (like sample sizes, ground truth establishment, expert qualifications, or MRMC studies) that you requested for an AI/ML medical device. Instead, it focuses on non-clinical testing for mechanical properties and material characteristics of an implantable medical device.

Therefore, I cannot fulfill your request for a table of acceptance criteria, reported device performance, sample sizes for test/training sets, expert information, adjudication methods, or MRMC study details from this document. The document explicitly states: "Not applicable; determination of substantial equivalence is not based on an assessment of clinical performance data." and "no further clinical or non-clinical testing is required to support the expanded indications for use of the subject systems."

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The IdentiTi™ ALIF Standalone Interbody System is indicated for spinal fusion procedures in skeletally mature patients. The IdentiTi ALIF Standalone Interbody System implants of ≤20° are a standalone system. The IdentiTi ALIF Standalone Interbody System implants of >20° must be used with supplemental spinal fixation systems cleared by the FDA for use in the lumbar spine in addition to the integrated screws.

The IdentiTi ALIF Standalone Interbody System is intended for use at one or two contiguous levels in the lumbar spine (L2-S1) for the treatment of degenerative disc disease (DDD) with up to Grade I spondylolisthesis at the involved level(s). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The IdentiTi ALIF Standalone Interbody System is intended for use on patients who have had at least six months of non-operative treatment. It is intended for use with autograft comprised of cancellous and/or corticocancellous bone graft.

The IdentiTiTM ALIF Standalone (SA) Interbody System is an integrated intervertebral body fusion device implanted from an anterior or anterolateral approach. The IdentiTi ALIF Standalone Interbody System interbody spacers are manufactured from a combination of commercially pure porous titanium (CP Ti Grade 2) per ASTM F67 and titanium alloy (Ti-6A1-4V ELI) per ASTM F136. The IdentiTi ALIF Standalone Interbody System interbody spacers are provided in multiple footprints with varying lengths, widths, heights, and angles of lordosis to accommodate individual patient anatomy. All interbody spacers feature an internal graft aperture for placement of graft material to promote fusion through the cage. The interbody spacer includes three screw holes to accept bone screws and bolts that are made of titanium alloy (Ti-6Al-4V ELI) per ASTM F136 in varying lengths and diameters.

The provided text is a 510(k) summary for a medical device called the "IdentiTi™ ALIF Standalone Interbody System". This document outlines the device's indications for use, its technical specifications, and a comparison to predicate devices, along with performance data from non-clinical testing.

However, the request asks for information about acceptance criteria and a study that proves the device meets those criteria, specifically in the context of an AI/human-in-the-loop study. The provided document explicitly states that no clinical performance data was used for the determination of substantial equivalence ("Not applicable; determination of substantial equivalence is not based on an assessment of clinical performance data.").

Therefore, most of the requested information regarding acceptance criteria, study design, sample sizes for test and training sets, expert consensus, adjudication methods, MRMC studies, standalone algorithm performance, and ground truth establishment cannot be found in this document, as it pertains to a different type of medical device submission (an interbody fusion system, not an AI-powered diagnostic/assistive tool) and regulatory pathway (510(k) based on substantial equivalence through non-clinical data).

Here is a summary of what can be extracted from the document in relation to the prompt:

1. A table of acceptance criteria and the reported device performance:

• Acceptance Criteria (Implicitly based on substantial equivalence to predicate devices): The device is substantially equivalent in terms of:
  • Intended Use
  • Indications for Use
  • Design
  • Function
  • Technology
  • Performance (based on nonclinical testing)
• Reported Device Performance (from nonclinical testing):
  • ASTM F2077 static & dynamic axial compression, static & dynamic 0 compression-shear
  • ASTM F1877 - particulate analysis
  • ASTM F1714 gravimetric analysis
  • ASTM F2267 subsidence
  • Static push-out
  • Screw push-out
• Conclusion: The results "demonstrate that the proposed IdentiTi™ ALIF Standalone Interbody System is substantially equivalent to the predicate devices for nonclinical testing."

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):

• Not applicable. This document describes non-clinical, mechanical testing of a physical implant device, not a study involving a "test set" of patient data for an AI algorithm.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

• Not applicable. Ground truth in the context of diagnostic performance or AI algorithms is not discussed. The "ground truth" for this device's performance is derived from standardized mechanical testing protocols.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:

• Not applicable.

5. 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:

• No MRMC study was done. This is not an AI device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

• Not applicable. This is not an AI device.

7. The type of ground truth used (expert concensus, pathology, outcomes data, etc):

• For the physical device's performance, the "ground truth" is adherence to established ASTM (American Society for Testing and Materials) standards for intervertebral body fusion devices. This is a form of engineering or mechanical testing standard, not clinical ground truth.

8. The sample size for the training set:

• Not applicable. There is no training set for an AI algorithm mentioned.

9. How the ground truth for the training set was established:

• Not applicable. There is no training set for an AI algorithm mentioned.

In summary, the provided document details the regulatory clearance of a physical medical implant device based on substantial equivalence established through non-clinical bench testing, not on the performance of an AI algorithm or clinical studies requiring human-in-the-loop assessments. Therefore, most of the questions relating to AI performance metrics are outside the scope of this specific document.

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