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The OptiMesh Multiplanar Expandable Interbody Fusion System is indicated for use as an adjunct to fusion in an intervertebral body fusion at one level in the lumbar spine from L2 to S1 in skeletally mature patients with degenerative disc disease (DDD) with up to Grade I spondylolisthesis at the involved level. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history, physical examination, and radios. Eligible patients shall have undergone six (6) months of conservative (non-operative) care. The OptiMesh device with compatible allograft, or a bone void filler as cleared by FDA for use in intervertebral body fusion to facilitate fusion, is intended for use with supplemental posterior fixation systems intended for use in the lumbar spine.

AFT is intended for use as a bone void filler in the extremities, spine, intervertebral disc space, and pelvis for voids or gaps that are not intrinsic to the stability of the bony structure. AFT is indicated for use in the treatment of osseous defects caused by surgery or traumatic injury. When used in intervertebral body fusion procedures, AFT must be used on its own with an intervertebral body graff containment device cleared by FDA for use with a bone void filler.

The OptiMesh Multiplanar Expandable Interbody Fusion System is an intervertebral body graft containment device that is a non-rigid, implanted spinal device that is designed to contain bone graft within its internal cavity. The device is inserted into the intervertebral body space of the spine and is intended as an adjunct to intervertebral body fusion.

AFT Allograft Filler Tube is composed of human demineralized bone matrix, human nondemineralized bone, and sodium hyaluronate. All components of AFT are resorbable. AFT is aseptically processed and provided pre-loaded into a disposable delivery tube.

The provided text describes a 510(k) premarket notification for the "OptiMesh Multiplanar Expandable Interbody Fusion System" with the addition of "AFT Allograft Filler Tube" as a compatible allograft. It outlines the purpose of the submission, device descriptions, indications for use, technological characteristics, and non-clinical/clinical testing. However, the document does not provide specific acceptance criteria or detailed study results in the format requested.

The FDA 510(k) clearance process focuses on demonstrating "substantial equivalence" to a legally marketed predicate device, rather than proving a device meets specific, quantifiable acceptance criteria with a detailed study report. The non-clinical and clinical data presented here are used to support this claim of substantial equivalence.

Based on the provided text, I can infer some aspects and highlight what is not present:

Inferred Information:

• Acceptance Criteria (Implied): The implied acceptance criteria revolve around demonstrating that the OptiMesh device with AFT performs comparably to the predicate device and the reference devices in terms of mechanical performance and biological impact, without introducing new safety or effectiveness concerns. This means that:
  • Mechanical performance of OptiMesh + AFT should be "as intended" and comparable to the reference device and ISO 23089-2 data.
  • Biological impact of AFT should be comparable to the reference bone graft.
  • Biocompatibility, pyrogenicity/endotoxin, sterilization, packaging, and shelf-life should be acceptable and comparable.
  • The risk profile should not be altered, and new safety/effectiveness issues should not arise.
• Study Proving Acceptance Criteria: The study used to demonstrate this is primarily a critical engineering and clinical comparison to a bone graft used in a prospective, multi-center, non-randomized, FDA and IRB approved performance goal clinical investigation.

Information NOT present explicitly in the document:

• Specific quantifications of acceptance criteria.
• A table of acceptance criteria and reported device performance with numerical values.
• Sample sizes used for the test set (e.g., number of patients/data points in the clinical investigation for comparison).
• Data provenance (country of origin, retrospective/prospective for the comparison study). While it mentions a "prospective" clinical investigation for the reference bone graft, it doesn't specify if the comparison itself involved new prospective data or a retrospective analysis of the existing investigation's data.
• Number of experts used to establish ground truth or their qualifications.
• Adjudication method for the test set.
• MRMC comparative effectiveness study details (effect size, human reader improvement). This type of study is more common for diagnostic imaging AI than for interbody fusion systems.
• Standalone algorithm performance (algorithm only without human-in-the-loop). This is a physical device, so "standalone algorithm performance" is not applicable in the typical AI/software sense.
• Type of ground truth used (pathology, outcomes data, etc.) beyond "clinical data" and "performance goal clinical investigation."
• Sample size for the training set. There's no mention of a "training set" in the context of an AI/machine learning model. This submission is for a physical medical device.
• How the ground truth for the training set was established. (Not applicable for this type of device submission).

Given these limitations, here is the best possible answer based only on the provided text, heavily inferring the "acceptance criteria" based on the substantial equivalence claims:

1. Table of Acceptance Criteria and Reported Device Performance

2. Sample size used for the test set and data provenance:
* Sample Size: Not specified in the given text.
* Data Provenance: The clinical data for comparison comes from a "prospective, multi-center, non-randomized, FDA and IRB approved performance goal clinical investigation" involving a reference bone graft. The country of origin is not specified but it's an FDA-approved study, implying it was likely conducted in the US or under FDA oversight for data acceptability.

3. Number of experts used to establish the ground truth for the test set and their qualifications:
* Not specified. The clinical investigation mentioned for comparison would have medical professionals involved, but the text does not detail the "ground truth" establishment process by experts in the context of this submission.

4. Adjudication method for the test set:
* Not specified.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, and its effect size:
* No, an MRMC study is not mentioned. This type of study is typically for evaluating diagnostic imaging systems where human readers interpret medical images. This submission is for a physical interbody fusion system.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:
* No, this concept is not applicable. The device is a physical medical implant, not an AI algorithm.

7. The type of ground truth used:
* The term "ground truth" is not explicitly used in the context of a dataset for algorithmic evaluation. However, for the clinical performance comparison, the "performance goal clinical investigation" likely established clinical outcomes (e.g., fusion rates, pain reduction, adverse events) as the de facto "truth" against which the subject device's performance (via comparison to a reference bone graft) was evaluated.

8. The sample size for the training set:
* Not applicable. This submission is for a physical medical device, not an AI/machine learning model that would require a training set.

9. How the ground truth for the training set was established:
* Not applicable, as there is no training set for an AI model.

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The OptiMesh Multiplanar Expandable Interbody Fusion System is indicated for use as an adjunct to fusion in an intervertebral body fusion at one level in the lumbar spine from L2 to S1 in skeletally mature patients with degenerative disc disease (DDD) with up to Grade I spondylolisthesis at the involved level. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history, physical examination, and radios. Eligible patients shall have undergone six (6) months of conservative (non-operative) care. The OptiMesh device with compatible allograft is intended for use with supplemental posterior fixation systems intended for use in the lumbar spine.

The OptiMesh Multiplanar Expandable Interbody Fusion System is an intervertebral body graft containment device that is a non-rigid, implanted spinal device designed to contain bone graft within its internal cavity. The device is inserted into the intervertebral body space of the spine and is intended as an adjunct to intervertebral body fusion.

The OptiMesh Lordotic device incorporates an asymmetrical dual chamber mesh with a larger chamber in the anterior portion of the disc space than in the posterior. Due to the asymmetry of the two mesh chambers when filled, the implant is designed to result in a lordotic shape.

The provided document is a 510(k) summary for the OptiMesh Multiplanar Expandable Interbody Fusion System. This document does not describe a study involving an AI/CADe device, human readers, or a test set with ground truth established by experts.

Instead, this document describes a medical device (an intervertebral body fusion system) and its mechanical and design properties. The non-clinical testing performed focuses on benchtop performance ASTM testing and risk assessment to demonstrate equivalence to a predicate device.

Therefore, I cannot provide the requested information, such as acceptance criteria for AI performance, sample sizes for test/training sets, expert qualifications, or adjudication methods, as these concepts are not applicable to the information presented in this 510(k) summary.

In summary, the provided document does not contain information about an AI/CADe device study to fulfill the prompt's requirements.

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The Spineology Interbody Fusion System (SIFS) is indicated for use as an adjunct to fusion in an intervertebral body fusion at one level in the lumbar spine from L2 to S1 in skeletally mature patients with degenerative disc disease (DDD) with up to Grade 1 spondylolisthesis at the involved level. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history, physical examination, and radiographic studies. Eligible patients shall have undergone six (6) months of conservative (non-operative) care. SIFS with compatible allograft and autograft is intended for use with supplemental posterior fixation systems intended for use in the lumbar spine.

The Spineology Interbody Fusion System (SIFS) is a lumber intervertebral body fusion device comprised of a PET (polyethylene terephthalate) mesh bag designed to contain compatible allograft and autograft as an adjunct to fusion for the treatment of degenerative disc disease. The device is placed into the prepared intervertebral disc space and then is packed with bone graft. The resulting SIFS implant is used with posterior supplemental fixation systems forming the completed SIFS construct.

The provided text describes the acceptance criteria and the study that proves the Spineology Interbody Fusion System (SIFS) meets these criteria. It does not describe an AI/ML device but rather a medical implant. Therefore, the questions related to AI/ML specific aspects (e.g., test set ground truth, MRMC study, standalone algorithm performance, training set) are not applicable to this document. The focus below will be on the information provided regarding the device's clinical and non-clinical performance and acceptance criteria.

Acceptance Criteria and Device Performance for Spineology Interbody Fusion System

This document outlines the evaluation of the Spineology Interbody Fusion System (SIFS), an intervertebral body graft containment device, for De Novo classification. The acceptance criteria are derived from both non-clinical/bench testing and a clinical study designed to demonstrate the device's safety and effectiveness.

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are established through a combination of non-clinical performance benchmarks (where applicable) and primary clinical endpoints.

2. Sample Sizes and Data Provenance

• Clinical Study Sample Size:
  • Test Set (Clinical Study Cohort): 102 subjects were enrolled and treated across 10 clinical sites.
  • Follow-up at 24 Months: 96 subjects provided complete data in-window (95.0% follow-up rate). Fusion assessment was conducted on 97 subjects (considering 12- and 24-month assessments).
• Data Provenance: The data is from a 24-month, prospective, single-arm, multi-center clinical study (G140140). The location of the clinical sites is not specified beyond "multi-center," but typically for FDA De Novo, such studies are conducted in the US or with data acceptable to the FDA. The study was based on a previously conducted prospective, randomized, multi-center study (G030106) for the same device. Given the context of a US FDA De Novo submission, it is highly likely that the centers were primarily in the United States, and the data is prospective.

3. Number of Experts and Qualifications for Ground Truth (Clinical Study)

• Ground Truth for Fusion: "Fusion was assessed by independent radiologists at the 12-month time point, and again at 24 months for those subjects who had not fused."
• Number of Experts: Not explicitly stated how many independent radiologists assessed each case, nor is their specific qualification (e.g., years of experience) mentioned. However, "independent radiologists" implies qualified medical professionals specialized in interpreting spinal imaging.

4. Adjudication Method (Clinical Study Test Set)

• The document implies that "independent radiologists" assessed fusion, but it does not specify an adjudication method (e.g., 2+1, 3+1 consensus process) for discrepancies between readers if multiple readers were used per case. It states fusion was "assessed by independent radiologists," which could mean one radiologist per case or multiple without a defined consensus process in the provided text.

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

• No MRMC study was conducted. This was a single-arm study evaluating the device's performance, not a comparative effectiveness study involving human readers with/without AI assistance. The device is an implant, not an AI diagnostic tool.

6. Standalone (Algorithm Only) Performance

• Not Applicable. This is a medical implant, not an algorithm. Therefore, "standalone (i.e., algorithm only without human-in-the-loop performance)" is not relevant.

7. Type of Ground Truth Used (Clinical Study)

• Combination of Clinical Outcome Measures and Radiographic Assessment:
  • Pain and Function: Ground truth derived from patient-reported outcomes (Visual Analog Scale for pain, Oswestry Disability Index for function).
  • Fusion: Ground truth established through "bridging bone demonstrated on CT Scan," assessed by independent radiologists. This is a radiographic ground truth.
  • Safety: Ground truth based on the occurrence and classification of adverse events, assessed by a Clinical Events Committee (CEC). This involves medical record review and expert medical judgment.

8. Sample Size for the Training Set

• Not Applicable. This is a human-implanted medical device, not an AI/ML algorithm. There is no concept of a "training set" in the context of device development as described here. The clinical study served as the primary evidence to demonstrate safety and effectiveness for regulatory approval.

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

• Not Applicable. As there is no training set for an AI/ML algorithm, this question is not relevant. The clinical study's data, as described in point 7, formed the basis of the evidence for the device's performance.

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