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The Spine360 Stingray Cervical Interbody Fusion System is indicated for use in skeletally mature patients with degenerative disc disease (DDD) of the cervical spine with accompanying radicular symptoms at one disc level. DDD is defined as discogenic pain with degeneration of the disc confirmed by patient history and radiographic studies. The Spine 360 Cervical Interbody Fusion System implants are used to facilitate intervertebral body fusion in the cervical spine and are placed via an anterior approach at the C3 to T1 disc levels using autograft bone. The Spine 360 Cervical Interbody Fusion System implants are to be used with supplemental fixation. Patients should have at least six (6) weeks of non-operative treatment prior to treatment with an intervertebral cage.

The Stingray Cervical Cage was developed as an intercorporal implant for anterior cervical spondylosis. Stingray is a system of wedge-shaped implants and instruments designed for anterior cervical interbody fusion (ACF). In the lateral view, the implant has a 3.5° lordotic form. The Stingray Cervical Cage has a flat top and bottom. Materials: PEEK-OPTIMA LT1 polymer (ASTM F2026 Standard Specification for Polyetheretherketone (PEEK) Polymers for Surgical Implant Applications) and tantalum according to ASTM F560.

Here's an analysis of the provided text regarding the acceptance criteria and supporting study for the Spine 360 Cervical Interbody Fusion System (K122085), framed according to your requested information.

Please note that this is a medical device submission, not an AI/software device. Therefore, many of the requested fields related to AI performance, human readers, training sets, and ground truth in the context of an algorithm will not be applicable or will need to be reinterpreted in the context of a physical device.

Acceptance Criteria and Study for Spine 360 Cervical Interbody Fusion System (K122085)

This device is a physical medical implant (interbody fusion system) and not an AI or software-based medical device. Therefore, the "acceptance criteria" and "device performance" are related to mechanical and material properties, not algorithmic accuracy or human reader improvement. The "study" refers to non-clinical (mechanical) testing based on ASTM standards.

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for this medical device are based on demonstrating mechanical equivalence or superiority to predicate devices and meeting established biomechanical tissue tolerances for the cervical spine. The performance is reported as meeting or exceeding these criteria.

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

• Test Set Sample Size: The document does not specify the exact number of devices tested for each mechanical test. However, standards like ASTM F2077-11 typically require a minimum number of samples for statistically valid testing (e.g., 5-6 samples per test group). The tests are conducted on manufactured devices, not human data.
• Data Provenance: The data is generated from non-clinical (laboratory) mechanical testing of the physical device. It is not patient data, nor does it have a country of origin in that sense. It's a prospective testing design to evaluate the device against established engineering standards.

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

• This question is not applicable to a physical medical device. "Ground truth" in this context refers to established engineering standards (ASTM standards) and biomechanical properties of the human spine. The "experts" would be the engineers and scientists who developed these standards and conducted the testing, not clinical experts establishing ground truth from patient data.

4. Adjudication Method for the Test Set

• This question is not applicable as there is no human interpretation or adjudication of test results in the clinical sense. The results of the mechanical tests are quantitative measurements against predefined criteria in the ASTM standards.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, and the effect size of how much human readers improve with AI vs without AI assistance.

• This device is a physical medical implant, not an AI or software device. Therefore, an MRMC comparative effectiveness study involving human readers and AI assistance is not applicable.

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

• This device is a physical medical implant, not an algorithm. Therefore, "standalone algorithm performance" is not applicable.

7. The Type of Ground Truth Used

• The "ground truth" for this device's performance relies on established engineering standards (ASTM F2077-11, F2267-04) and recognized biomechanical properties and tolerances of the human cervical spine. The objective is to ensure the device's mechanical integrity and safety when implanted.

8. The Sample Size for the Training Set

• This device is a physical medical implant, not an AI with a training set. Therefore, this question is not applicable.

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

• This device is a physical medical implant, not an AI with a training set. Therefore, this question is not applicable.

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The Spine 360 Lumbar Interbody Fusion System is indicated for intervertebral body fusion procedures in skeletally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L2-S1. Degenerative disc disease is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may have up to Grade 1 spondylolisthesis or retrolisthesis at the involved level(s). Spine 360 Lumbar Interbody Fusion System implants are to be used with autogenous bone graft. The Spine 360 Lumbar Interbody Fusion System implants are to be used with supplemental fixation. Patients should have at least (6) months of non-operative treatment prior to treatment with an intervertebral cage. Patients with previous non-fusion spinal surgery at involved level may be treated with the device.

The SHARK implant (PLIF) consists of rectangular blocks with a tapered nose. The BULLSHARK implant (PLIF) is rectangular in shape with a conical nose. Both devices have parallel configurations of various heights.

The TIGER implant (TLIF) consists of banana shaped blocks in a parallel configuration of various heights. Large bone graft windows are located through the body of the device to allow for placement of bone graft and facilitate fusion.

The GREAT WHITE implants (ALIF) are oval shaped blocks, which are available in a two lordotic configurations (7° and 13°) of various heights. The hollow cylinders allow for placement of bone graft and facilitate fusion.

Materials: PEEK-OPTIMA LT1 polymer (ASTM F2026 Standard Specification for Polyetheretherketone (PEEK) Polymers for Surgical Implant Applications) and tantalum according to ASTM F560.

The provided text is a 510(k) summary for the "Spine 360 Interbody Fusion System," which is a medical device. This document focuses on demonstrating substantial equivalence to previously approved devices, not on proving that the device meets specific performance criteria through clinical studies or extensive testing that would generate acceptance criteria and reported performance in the way an AI/software device would.

Therefore, many of the requested elements for an AI or software device (like sample size for test sets, number of experts for ground truth, adjudication methods, multi-reader multi-case studies, standalone performance, training set details, etc.) are not applicable to this type of device submission.

However, I can extract the information that is relevant to the provided document:

Acceptance Criteria and Device Performance (for Substantial Equivalence)

The core "acceptance criteria" for a 510(k) submission like this is substantial equivalence to predicate devices. This means demonstrating that the new device is as safe and effective as a legally marketed device that is already on the market. The reported "performance" is primarily a comparison of key features and the results of non-clinical (bench) testing against established standards.

1. Table of Acceptance Criteria and Reported Device Performance

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

• Sample Size for Test Set: This is a non-clinical device. The "test set" consists of the physical devices themselves and test coupons for material characterization. The document does not specify a numerical sample size for the mechanical testing, but these tests are typically performed on a statistically relevant number of units.
• Data Provenance: The mechanical tests (static compression, dynamic compression, subsidence) are bench tests conducted in a laboratory setting, not on patient data. The origin of the data is therefore the testing facility. The document does not specify the country of origin of the testing.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

• Not Applicable. For a physical implant device, ground truth as it pertains to AI/software evaluation (e.g., expert consensus on medical images) is not relevant. The "ground truth" for material properties and mechanical performance is established by recognized ASTM standards and physical measurements.

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

• Not Applicable. Adjudication methods are typically for resolving discrepancies in expert interpretations of medical data, which is not part of this device submission.

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. This is a physical interbody fusion system, not an AI or imaging software. MRMC studies are not applicable.

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

• Not Applicable. This is a physical implant.

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

• The "ground truth" for this device's performance is derived from:
  • Material Specifications: Compliance with ASTM F2026 (for PEEK) and ASTM F560 (for Tantalum) standards.
  • Mechanical Testing Standards: Adherence to ASTM F2077 (static and dynamic compression) and ASTM F2267 (subsidence) test methods and their implied performance requirements.
  • Substantial Equivalence: Comparison against the design, materials, intended use, and performance of legally marketed predicate devices.

8. The sample size for the training set

• Not Applicable. This device does not use machine learning, 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, this question is not applicable.

Summary of the Study (or Basis for Clearance):

The "study" in this context is the non-clinical testing and comparison to predicate devices for demonstrating substantial equivalence.

• Non-Clinical Test Summary: The application included non-clinical tests:
  • Static and dynamic compression testing according to ASTM F2077 "Test Methods for Intervertebral Body Fusion Devices."
  • Subsidence testing according to ASTM F2267 "Measuring Load Induced Subsidence of Intervertebral Body Fusion Device Under Static Axial Compression."
• Clinical Test Summary: "No clinical studies were performed."
• Basis for Clearance: The Spine 360 Interbody Fusion System was found "substantially equivalent" to predicate devices (BRANTIGAN I/F CAGE (P960025) and Lucent Straight Intervertebral Body Fusion Device (K072120)) based on:
  • Identical intended use (intervertebral body fusion for DDD in lumbar spine).
  • Similar design, materials (predominantly PEEK Optima LT1 and tantalum markers), and function.
  • Successful completion of non-clinical mechanical testing demonstrating performance comparable to what is expected for such devices and predicates.

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