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The EXPEDIUM Verse System is intended to provide immobilization of spinal segments in sketally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The EXPEDIUM Verse System is intended for noncervical pedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor, pseudoarthrosis; and failed previous fusion in skeletally mature patients.

When used in a posterior percutaneous approach with MIS instrumentation, the EXPEDIUM Verse System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, and/or lordosis); tumor, pseudoarthrosis; and failed previous fusion in skeletally mature patients.

When used for posterior non-cervical pediativ patients, the EXPEDIUM Verse System metallic implants are indicated as an adjunct to treat adolescent idiopathic scoliosis. The EXPEDIUM Verse system is intended to be used with autograft and/or allograft. Pediatric pedicle screw fixation is limited to a posterior approach.

When used for posterior non-cervical pedicle screw fixation in pediatric patients, the EXPEDIUM® System is indicated as an adjunct to fusion to treat progressive spinal deformities (i.e. scoliosis, or lordosis) including adolescent idiopathic scoliosis, neuromuscular scoliosis, and congenital scoliosis. Additionally, the EXPEDIUM® System is intended to treat pediatric patients diagnosed with: spondylolisthesis/spondylolysis, fracture caused by tumor and/or trauma, pseudarthrosis, and/or failed previous fusion. The EXPEDIUM® System is intended to be used with autograft and/or allograft. Pediatric pedicle screw fixation is limited to a posterior approach.

When used in conjunction with CONFIDENCE High Viscosity Spinal Cement, the EXPEDIUM VERSE Fenestrated Screw Systems are 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 thoracic and lumbar spine in whom life expectancy is of insufficient duration to permit achievement of fusion. The EXPEDIUM Fenestrated Screw System augmented with the CONFIDENCE High Viscosity Spinal Cement is for use at spinal levels where the structural integrity of the spine is not severely compromised.

The EXPEDIUM fenestrated screws are polyaxial pedicle screws designed with a cannulation that runs the length of the screw shank and lateral fenestrations. The fenestrated screws are manufactured from titanium alloy (Ti-6Al-4V) conforming to ASTM F136. The EXPEDIUM VERSE® fenestrated screws are manufactured from titanium alloy (Ti-6Al-4V) conforming to ASTM F136 and cobalt chromium alloy (Co-28Cr-6Mo) conforming to ASTM F1537. The fenestrated screws are intended for use with components of the EXPEDIUM System such as rods and set screws to create an implant system to meet the patient's physiological and anatomical requirements. The EXPEDIUM VERSE® fenestrated screws are intended for use with components of the EXPEDIUM Spine System, including VERSE, to create an implant system to meet the patient's physiological and anatomical requirements.

The fenestrated screws may be used in conjunction with CONFIDENCE High Viscosity Spinal Cement a self-curing polymethylmethacrylate (PMMA) radiopaque bone cement. The CONFIDENCE Spinal Cement System® kits include the cement and accessories necessary to mix, prepare and deliver the cement. The fenestrated screw cannula connects the CONFIDENCE spinal cement delivery system to the fenestrated screw. An alignment guide facilitates orientation of the fenestrated screw to accept the fenestrated screw cannula for cement delivery. Please refer to the surgical technique manual.

The provided text is a 510(k) premarket notification letter from the FDA regarding the EXPEDIUM VERSE® Fenestrated Screw System. It focuses on the device's substantial equivalence to a predicate device, primarily addressing a labeling change for reprocessing of sterile fenestrated screws.

Critically, this document explicitly states: "No additional testing was conducted to support this submission."

Therefore, I cannot provide the information requested in your prompt regarding acceptance criteria and a study proving the device meets those criteria, as no such study or associated data is detailed in this document. The FDA clearance for this particular submission (K220374) was based on the device's substantial equivalence to an existing predicate device, not on new performance testing to prove specific acceptance criteria for AI or other advanced functionalities.

The queries in your prompt (e.g., sample size for test/training sets, expert consensus for ground truth, MRMC study, standalone algorithm performance) are highly relevant for the evaluation of AI/ML-driven medical devices, but they are not applicable to the information contained in this 510(k) summary, which concerns a physical medical device (spinal screws) and a labeling update.

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