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When used as a pedicle screw fixation system in skeletally mature patients, the Silhouette™ Spinal Fixation System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar, and sacral spine: degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and failed previous fusion (pseudarthrosis).

In addition, when used as a pedicle screw fixation system, the Silhouette Spinal Fixation System is indicated for use in patients:
a) having severe spondylolisthesis (Grade 3 and 4) at the L5-S1 joint
b) who are receiving fusions with autogenous graft only
c) who are having the device fixed or attached to the lumbar or sacral spine
d) who are having the device removed after the development of a solid fusion mass

When used as a hook and sacral screw system, the Silhouette Spinal Fixation System is intended for use in the treatment of degenerative disc disease (as defined by chronic back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies), idiopathic scoliosis, spondylolisthesis, kyphotic or lordotic deformity of the spine, loss of stability due to tumors, spinal stenosis, vertebral fracture or dislocation, pseudoarthrosis, and previous failed spinal fusion. When used for this indication, screws of the Silhouette Spinal Fixation System are intended for sacral illiac attachment only. Hook and transverse of the Silhouette Spinal Fixation System are intended for posterior thoracic only. As a whole, the levels of use for hook and sacral screw fixation of this system are T1 to the sacrum.

The Silhouette™ Spinal Fixation System is a temporary implant system used to correct spinal deformity and to facilitate the biological process of spinal fusion. This system is intended for posterior use in the thoracic, lumbar, and sacral areas of the spine. Implants in this system consist of hooks and/or screws and are intended to be removed after solid fusion has occurred. The system includes polyaxial screws of varying diameters and lengths; fixed screws of varying diameters and lengths; rods in varying lengths; hooks in varying designs; and transverse connectors in the various configurations of fixed, adjustable, variable angle offset and axial. All implant components are either top loading and top tightening. The implants in this system are manufactured from titanium alloy (Ti-6Al-4V) that conforms to ASTM F-136.

The provided text is a 510(k) Summary for the Silhouette™ Spinal Fixation System, which is a medical device. This type of regulatory submission in the United States focuses on establishing substantial equivalence to a predicate device, rather than proving the device meets specific performance criteria through a clinical study or extensive analytical testing.

Therefore, the supplied document does not contain the information requested regarding acceptance criteria and a study demonstrating that the device meets those criteria. The 510(k) summary primarily addresses:

• Device Description: What the device is and what it's made of.
• Intended Use: The medical conditions and anatomical locations for which the device is designed.
• Statement of Technological Comparison: A qualitative comparison to a legally marketed predicate device, highlighting that the new device has "similar mechanical properties" based on ISO mechanical testing (not clinical or human-in-the-loop studies).
• Regulatory Classification and Predicate Device: Identifies the classification and the previous devices it is substantially equivalent to.

Based on the provided text, here's an analysis of why the requested information cannot be extracted:

1. A table of acceptance criteria and the reported device performance: This information is not found in the summary. The summary mentions "mechanical testing carried out according to ASTM 1717-96 to validate the Variable Angle Connector and the Axial Connector." It states that this testing "demonstrated similar mechanical properties to the previously cleared Silhouette™ Spinal Fixation System components." However, specific acceptance criteria (e.g., minimum tensile strength, maximum displacement) and the exact reported performance values are not detailed.

2. Sample size used for the test set and the data provenance: Not applicable for the type of information provided. The "test set" in this context refers to mechanical test samples, not a clinical data set. The document does not specify the number of components tested for the mechanical validation. Data provenance (country, retrospective/prospective) is relevant for clinical studies, not for internal mechanical testing of device components.

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. "Ground truth" and "experts" are terms related to clinical or diagnostic accuracy studies, not mechanical component testing for spinal implants. The ground truth for mechanical testing would be the physical properties measured against industry standards.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable. Adjudication methods are used in clinical trials or diagnostic studies to resolve discrepancies in expert opinions, which is not relevant to mechanical testing.

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. MRMC studies, AI, and human reader performance are entirely unrelated to the mechanical performance of a spinal fixation system.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable. This refers to AI algorithm performance, which is not part of this device's evaluation.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): For the mechanical testing mentioned, the "ground truth" would be established engineering standards (ASTM F-136 for material, ASTM 1717-96 for mechanical testing).

8. The sample size for the training set: Not applicable. Training sets are relevant for machine learning algorithms, which are not involved here.

9. How the ground truth for the training set was established: Not applicable for the same reason as above.

In summary, the provided 510(k) summary focuses on demonstrating substantial equivalence through a comparison of device design, materials, and mechanical properties (using ASTM standards) to a predicate device, rather than reporting on clinical performance criteria, diagnostic accuracy, or AI system validation.

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