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E3D™-A Static Interbody Devices are thoraco-lumbar interbody fusion devices indicated at one or more levels of the thoracic spine (T1-T12), thoracolumbar junction (T12- L1), or lumbosacral spine (L1-S1) as an adjunct to fusion in patients with the following indications: degenerative disc disease (DDD), disc herniation (with myelopathy and/or radiculopathy), spondvlolisthesis, deformity (degenerative scoliosis or kyphosis), spinal stenosis, and failed previous fusion (pseudarthrosis). DDD is defined as discogenic back pain with degeneration of the disc as confirmed by history and radiographic studies. These patients should be skeletally mature and have had at least six (6) months of non-operative treatment. Devices are to be filled with autograft bone and/or allogenic bone graft composed of cancellous and/or corticocancellous bone. These devices are intended to be used with supplemental fixation systems that have been cleared for use in the thoracolumbosacral spine (e.g., posterior pedicle screw and rod systems, anterior plate systems, and anterior screw and rod systems). Hyperlordotic interbody devices (>20° lordosis) must be used with at least anterior supplemental fixation.

E3D™-A Integrated Interbody Devices are integrated lumbar interbody fusion devices intended for use in patients with degenerative disc disease (DDD) at one or two contiguous levels of the lumbosacral spine (L2-S1). 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 at least six (6) months of non-operative treatment. In addition, these patients may have up to Grade 1 spondylolisthesis or retrolisthesis at the involved level(s). Devices are to be filled with autograft bone and/or allogenic bone graft composed of cancellous and/or corticocancellous bone. These devices are intended to be used with three screws or anchors which accompany the implants. When used with screws, these devices are stand-alone interbody fusion devices. When used with anchors, these devices are intended for use with supplemental fixation (e.g., facet screws or posterior fixation). Hyperlordotic implants (>20° lordosis) are intended for use with supplemental fixation (e.g., facet screws or posterior fixation). When used without screws or anchors, these devices are intended for use with supplemental fixation (e.g., facet screws or posterior fixation).

When used for multilevel degenerative scoliosis or sagittal deformity, supplemental fixation that have been cleared for use in the thoracolumbosacral spine (e.g., posterior pedicle screw and rod systems, anterior plate systems, and anterior screw and rod systems) must be used.

The E3D™ -A Interbody System provides interbody fusion devices designed to provide structural stability during spinal fusion. The E3D™-A Interbody System consists of Interbodies offered in various sizes to accommodate surgical needs and anatomic requirements. The E3D™-A Interbodies were designed to be placed via an anterior approach. All Interbodies in the system are additively manufactured from titanium alloy powder, per ASTM F3001. The System offers both Static and Integrated Interbodies. The Integrated version is to be used in conjunction with three (3) screws that are subtractively manufactured from titanium alloy, per ASTM F136; or three (3) Anchors that are additively manufactured from titanium alloy per ASTM F3001.

The E3D™-A Interbody System's implants are available with and without HAnano Surface®, a 20-40 nanometer thin hydroxyapatite (HA) surface treatment. The surface treatment presents nano-scale topography on the entirety of the implant surface.

The purpose of this submission is to add larger footprints and Anchors.

This document is a 510(k) summary for the E3D™-A Interbody System, a medical device used for spinal fusion. The information provided heavily focuses on regulatory aspects and comparisons to predicate devices, rather than a detailed study proving the device meets specific acceptance criteria based on clinical performance. Therefore, I cannot provide a table of acceptance criteria and reported device performance directly from this text, as specific quantitative performance metrics and acceptance thresholds for clinical efficacy are not detailed.

However, I can extract information related to performance testing that supports the device's substantial equivalence.

Here's an analysis based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

As noted above, the document does not contain a typical table of clinical acceptance criteria (e.g., sensitivity, specificity, accuracy) and reported device performance. It instead describes mechanical performance testing against predicate devices and standards.

2. Sample Size Used for the Test Set and Data Provenance

The document mentions "worst-case implants" for mechanical testing, but does not specify the sample size (number of implants tested) for the test set. It does not mention clinical data or studies with human subjects, so there is no information on data provenance (country of origin, retrospective/prospective). This submission is for substantial equivalence based on technological characteristics and mechanical testing, not clinical performance.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

Not applicable. The document does not describe a clinical study or expert review for establishing ground truth, as the submission focuses on mechanical and design equivalence.

4. Adjudication Method for the Test Set

Not applicable. There is no mention of adjudication, as no clinical ground truth assessment or expert review is described.

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

Not applicable. This device is a physical intervertebral body fusion device, not an AI or software-based diagnostic tool, so an MRMC study is not relevant.

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

Not applicable. This device is a physical implant, not an algorithm.

7. The type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

For the mechanical testing, the "ground truth" would be the established performance standards of ASTM F2077 and the performance of the predicate devices. For the HAnano Surface®, the "ground truth" was established by Promimic's protocols accepted by FDA (reference K232432).

8. The Sample Size for the Training Set

Not applicable. This document describes a physical medical device and its regulatory submission, not a machine learning model, so there is no "training set."

9. How the Ground Truth for the Training Set was Established

Not applicable. As there is no training set mentioned, this question is not relevant.

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E3D™ -A Static Interbody Devices are thoraco-lumbar interbody fusion devices indicated at one or more levels of the thoracic spine (T1-T12), thoracolumbar junction (T12- L1), or lumbosacral spine (L1-S1) as an adjunct to fusion in patients with the following indications: degenerative disc disease (DDD), disc herniation (with myelopathy and/or radiculopathy), spondylolisthesis, deformity (degenerative scoliosis or kyphosis), spinal stenosis, and failed previous fusion (pseudarthrosis). DDD is defined as discogenic back pain with degeneration of the disc as confirmed by history and radiographic studies. These patients should be skeletally mature and have had at least six (6) months of non-operative treatment. Devices are to be filled with autograft bone and/or allogenic bone graft composed of cancellous and/or corticocancellous bone. These devices are intended to be used with supplemental fixation systems that have been cleared for use in the thoracolumbosacral spine (e.g., posterior pedicle screw and rod systems, anterior plate systems, and anterior screw and rod systems). Hyperlordotic interbody devices (≥20° lordosis) must be used with at least anterior supplemental fixation.

E3D™ -A Integrated Interbody Devices are integrated lumbar interbody fusion devices intended for use in patients with degenerative disc disease (DDD) at one or two contiguous levels of the lumbosacral spine (L2-S1). 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 at least six (6) months of non-operative treatment. In addition, these patients may have up to Grade 1 spondylolisthesis or retrolisthesis at the involved level(s). Devices are to be filled with autograft bone and/or allogenic bone graft composed of cancellous and/or corticocancellous bone. These devices are intended to be used with three screws or anchors which accompany the implants. When used with screws, these devices are stand-alone interbody fusion devices. When used with anchors, these devices are intended for use with supplemental fixation (e.g., facet screws or posterior fixation). Hyperlordotic implants (≥20° lordosis) are intended for use with supplemental fixation (e.g., facet screws or posterior fixation). When used without screws or anchors, these devices are intended for use with supplemental fixation (e.g., facet screws or posterior fixation).

When used for multilevel degenerative scoliosis or sagittal deformity, supplemental fixation that have been cleared for use in the thoracolumbosacral spine (e.g., posterior pedicle screw and rod systems, anterior plate systems, and anterior screw and rod systems) must be used.

The E3D™ -A Interbody System provides interbody fusion devices designed to provide structural stability during spinal fusion. The E3D™-A Interbody System consists of interbodies offered in various sizes to accommodate surgical needs and anatomic requirements. The E3D-A Interbodies were designed to be placed via an anterior approach. All interbodies in the system are additively manufactured from titanium alloy powder, per ASTM F3001. The System offers both Static and Integrated Interbodies. The Integrated version is to be used in conjunction with three (3) screws that are subtractively manufactured from titanium alloy, per ASTM F136.

The E3D-A Interbody System's implants are available with and without HA®®º Surface®, a 20-40 nanometer thin hydroxyapatite (HA) surface treatment. The surface treatment presents nano-scale topography on the entirety of the implant surface.

The provided text describes a medical device, the E3D™-A Interbody System, and its clearance by the FDA based on substantial equivalence to predicate devices, rather than a study proving the device meets specific acceptance criteria through clinical performance or AI/software analysis.

Therefore, the information required to answer the prompt (acceptance criteria for device performance, sample sizes, expert involvement, ground truth, etc.) is not present in the provided text. The document focuses on regulatory clearance for an interbody fusion device, primarily detailing its physical characteristics, indications for use, and comparison to existing similar devices.

Specifically:

• No acceptance criteria or device performance report is provided in the context of a study for clinical efficacy or AI performance. The "Performance Data" section solely refers to physical and material testing (ASTM F2077 for dynamic compression shear testing and Promimic's protocols for the HA surface treatment), not clinical outcomes or AI model performance.
• No mention of a test set, training set, or data provenance for any AI/software component. The device is an interbody fusion system, a physical implant.
• No information on experts, ground truth, or adjudication methods as these are not relevant to the type of regulatory submission described (510(k) for a physical implant based on substantial equivalence).
• No Multi-Reader Multi-Case (MRMC) comparative effectiveness study is mentioned, as this device does not involve human readers interpreting images with or without AI assistance.
• No standalone algorithm performance is mentioned, as there is no algorithm described.

In summary, the provided document is a 510(k) clearance letter and summary for a physical medical device (an interbody fusion system), not a document detailing the performance evaluation of an AI or software device.

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