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The Life Spine Cement Restrictor is intended for use in orthopedic surgeries involving the femoral canal, tibia, or the humerus.

This device is NOT intended for use in any spinal indications or acetabular cup surgeries. The safety and effectiveness of this device for implantation in the spine has not been established.

The device is a straight or tapered hollow box with a fenestrated surface on many sides. The geometry is designed to contain bone cement. The exterior surface of the device has teeth to prevent the device from migrating from the desired location. The device is manufactured from PEEK-OPTIMA®. The device is made in a variety of sizes. The responsible surgeon will determine the correct size of the device in accordance with the anatomical size of the individual patient.

The provided document is a 510(k) summary for the Life Spine Cement Restrictor. It focuses on demonstrating substantial equivalence to previously cleared devices rather than reporting on specific performance criteria and a study proving those criteria are met, as would be expected for a novel device or a device with new indications requiring clinical data.

Based on the provided text, here's an analysis regarding your request:

1. Table of Acceptance Criteria and Reported Device Performance:

The document states: "This is designated as a non-load bearing Class II device under CFR 21 878.3300 and no mechanical tests are required." This explicitly indicates that no specific performance acceptance criteria or corresponding test results are provided in this submission. The regulatory pathway chosen (Special 510(k) Summary) relies on substantial equivalence.

Therefore, a table of acceptance criteria and reported device performance cannot be generated from the given text.

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

No performance data, test sets, or data provenance (e.g., country of origin, retrospective/prospective) are mentioned because the device is classified as non-load bearing and no mechanical tests were required. The submission relies on substantial equivalence to predicate devices, not new performance data.

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

Not applicable. As no test set performance data is provided, there is no mention of experts establishing ground truth for such a set.

4. Adjudication Method for the Test Set:

Not applicable. No test set or associated adjudication methods are described.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

Not applicable. No MRMC study was done or reported in this document.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study:

Not applicable. This is a medical device (cement restrictor), not an AI algorithm.

7. Type of Ground Truth Used:

Not applicable. No data requiring ground truth establishment is presented. The basis for clearance is substantial equivalence to predicate devices.

8. Sample Size for the Training Set:

Not applicable. This is not an AI/algorithm-based device.

9. How the Ground Truth for the Training Set Was Established:

Not applicable. This is not an AI/algorithm-based device.

Summary from the Document:

The Life Spine Cement Restrictor was cleared based on its substantial equivalence to previously cleared predicate devices in terms of indications for use, design, function, and materials. Because it is a non-load bearing Class II device (CFR 21 878.3300), no mechanical tests or associated performance data were required for this submission. The critical aspect of its clearance was the comparison to existing devices on the market, not through a study demonstrating specific acceptance criteria for its own performance.

A key warning added during the 510(k) process is: "WARNING: THIS DEVICE IS NOT INTENDED FOR ANY SPINAL INDICATIONS. THE SAFETY AND EFFECTIVENESS OF THIS DEVICE WHEN IMPLANTED IN THE SPINE HAVE NOT BEEN ESTABLISHED." This indicates that while it met the criteria for substantial equivalence for its intended use (femoral canal, tibia, or humerus), there was specific concern about off-label use in the spine.

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