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When used as a pedicle screw fixation system in the non-cervical posterior spine in skeletally mature patients, the Mahe Perfect Spine - Pedicle Screw System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic. Iumbar and sacral spine: (1) degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies), (2) degenerative spondylolisthesis with objective evidence of neurologic impairment, (3) fracture, (4) dislocation, deformities or curvatures (i.e., scoliosis, kyphosis, and/or lordosis), (5) tumor, and (6) failed previous fusion (i.e. pseudarthrosis). In addition, when used as a pedicle screw system placed between L3 and S1, the Mahe Perfect Spine - Pedicle Screw System is indicated for the treatment of severe spondylolisthesis (Grade 3 and 4) in skeletally mature patients receiving fusion with autologous bone graft and with removal of the device after solid fusion is established.

When used as a posterior, non-cervical, non-pedicle screw fixation system, the Mahe Perfect Spine - Pedicle Screw System is intended for use in skeletally mature patients and pediatric patients for the following indications: (1) degenerative disc disease (as defined by back pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies), (2) spondylolisthesis, (3) fracture, (4) spinal deformities (i.e., scoliosis, kyphosis, and/or lordosis), (5) spinal stenosis, (6) tumor resection, and/or (7) unsuccessful previous attempts at spinal fusion (pseudoarthrosis).

When intended for anterolateral fixation of the T6-L5 spine the Mahe Perfect Spine - Pedicle Screw System is indicated for: (1) degenerative disc disease (back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies), (2) spondylolisthesis, (3) trauma (i.e. fracture or dislocation), (4) spinal stenosis, (5) deformities or curvatures (i.e. scoliosis, kyphosis, and/or lordosis}, (6) tumor and (7) failed previous fusion.

The Mahe Perfect Spine - Pedicle Screw System consists of a variety of shapes and sizes of rods, hooks, monoaxial and polyaxial screws, cross connectors, as well as appropriate instrumentation.

The Mahe Perfect Spine - Pedicle Screw System components are fabricated from titanium alloy per ASTM F136.

The system is sold non-sterile, the products have to be sterilized prior to use.

The provided text details a 510(k) submission for the Mahe Perfect Spine - Pedicle Screw System. This is a medical device for spinal fixation, not an AI/ML powered device. As such, the concept of "acceptance criteria" and "study that proves the device meets the acceptance criteria" as it relates to AI/ML device performance (e.g., accuracy, sensitivity, specificity, F1-score) is not applicable here.

Instead, the submission focuses on demonstrating substantial equivalence to existing predicate devices based on non-clinical performance data and technological characteristics.

Here's how the information provided relates to the typical framework for medical device clearance in this context:

1. Table of Acceptance Criteria and Reported Device Performance:

Since this is not an AI/ML device, there are no "acceptance criteria" for metrics like sensitivity or accuracy. The "acceptance criteria" here are implicit in demonstrating substantial equivalence through mechanical testing, material specifications, and intended use.

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

• Test Set: The "test set" in this context refers to the samples of the device components that underwent mechanical testing. The specific number of samples for each test (static compression bending, static torsion, dynamic compression bending, etc.) is not explicitly stated in the provided text.
• Data Provenance: The data comes from non-clinical laboratory testing performed on the device itself ("the worst case construct"). There is no mention of country of origin for the data or whether it's retrospective or prospective, as it's a materials/mechanical engineering study, not a clinical trial.

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

• This question is not applicable to this type of device submission. "Ground truth" in the context of expert consensus is relevant for diagnostic AI/ML devices where experts annotate data for algorithm training and evaluation. For a spinal fixation system, the "ground truth" for its performance is derived from standardized mechanical testing against established engineering benchmarks and comparison to predicate devices, not expert human assessment of images or clinical outcomes in a test set.

4. Adjudication Method:

• Not applicable. Adjudication methods (like 2+1, 3+1) are used for resolving disagreements among human experts in establishing ground truth for diagnostic AI/ML systems. This is a mechanical device, not an AI/ML diagnostic.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done:

• No. An MRMC study is relevant for evaluating the impact of AI on human reader performance in diagnostic tasks. This device is a surgical implant, not a diagnostic tool that assists human readers.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

• Not applicable. This submission is for a physical medical device, not a software algorithm.

7. The Type of Ground Truth Used:

• The "ground truth" for this device's performance is derived from objective, standardized mechanical testing results (e.g., measurements of bending strength, torsion resistance, fatigue life) compared against established performance characteristics of legally marketed predicate devices and relevant industry standards (ASTM F1717-10, ASTM F2193-02, ASTM F1798).

8. The Sample Size for the Training Set:

• Not applicable. There is no "training set" in the context of a mechanical medical device submission. Training sets are for machine learning algorithms.

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

• Not applicable. As there is no training set, this question is not relevant.

In summary: The provided document is for a traditional medical device (spinal fixation system) seeking 510(k) clearance based on substantial equivalence to predicate devices, primarily supported by non-clinical mechanical performance data and material specifications. The questions concerning AI/ML evaluation metrics, expert consensus, and ground truth establishment for algorithms are outside the scope of this submission.

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When intended for pedicle screw fixation from L1-S1, the indications include immobilization and stabilization of spinal segments in skeletally mature patients 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 disc disease (defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies), degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, deformities or curvatures (i.e. scoliosis, kyphosis, and/or lordosis), tumor, and failed previous fusion.

As a pedicle screw system placed between L3 and S1, the indications include Grade 3 or Grade 4 spondylolisthesis, when utilizing autologous bone graft, when affixed to the posterior lumbosacral spine, and intended to be removed after solid fusion is established.

After solid fusion occurs, these devices serve no functional purpose and should be removed. In most cases, removal is indicated because the implants are not intended to transfer or support forces developed during normal activities. Any decision to remove the device must be made by the physician and the patient, taking into consideration the patient's general medical condition and the potential risk to the patient of a second surgical procedure.

PathFinder is a modification to the existing Spinal Concepts Inc. InCompass polyaxial screw design. The design modification allows the components to be implanted through an open or mini open surgical technique. The mini-open surgical technique is conducted using k-wires and cannulated PathFinder screws.

The information provided is for the Spinal Concepts, Inc. PathFinder, which is a medical device (spinal fixation system) and not an AI/ML powered device. Therefore, a study proving the device meets acceptance criteria related to AI/ML performance (like those requested in the prompt regarding sensitivity, specificity, MRMC studies, ground truth establishment for training/test sets, etc.) is not applicable here.

The provided document describes a 510(k) submission for a design modification of an existing spinal fixation system. The assessment for such a device focuses on mechanical testing, biocompatibility, and substantial equivalence to a predicate device, rather than AI/ML performance metrics.

Specifically, the document states:

• MECHANICAL TEST DATA: "Mechanical testing data, including data collected in accordance with ASTM 1717 and ASTM 1798, was collected to verify that the design changes met established design requirements."

This indicates that the device's acceptance criteria are related to its mechanical performance and safety, as demonstrated through compliance with specific ASTM standards. The study mentioned is a series of mechanical tests.

Therefore, I cannot provide a table of acceptance criteria and reported device performance in the context of AI/ML metrics, nor can I answer questions about sample sizes for test/training sets, data provenance, expert ground truth, adjudication methods, or MRMC studies, as these concepts do not apply to this type of device and the information provided.

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