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When used as a lumbar intervertebral body fusion device, the Biomet Spine Fusion System is intended for spinal fusion procedures to be used with autogenous bone graft in skeletally mature patients with degenerative disc disease ("DDD") at one or two contiguous spinal levels from L2-S1. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should have had six months of non-operative treatment. These DDD patients may have had a previous non-fusion spinal surgery at the involved spinal level(s), and may have up to Grade 1 spondylolisthesis or retrolisthesis at the involved level(s). The Biomet Spine Fusion System is to be implanted via an anterior or posterior approach and is to be combined with supplemental fixation. Approved supplemental fixation systems include the Biomet Spinal Fixation System. The expandable interbody fusion devices are not indicated for vertebral body replacement.

The Biomet Spine Fusion System implants are intervertebral body fusion/vertebral body replacement devices consisting of a rectangular or semi-rectangular shape and various heights and footprints. The devices have a hollowed out central area to accommodate bone graft. The upper and lower surfaces of the devices have a series of transverse grooves formed to improve stability and fixation once the device is inserted. The implants are available in a variety of sizes and configurations to approximate anatomical variation in different vertebral levels and/or patient anatomy. The implants are made of PEEK (OPTIMA LT1®) per ASTM F2026, titanium alloy (Ti-6A1-4V ELI) per ASTM F136, commercially pure titanium per ASTM F1580, and may include tantalum markers per ASTM F560. The expandable Biomet Spine Fusion System implants incorporate PEEK (OPTIMA LT1® per ASTM F2026) spacer components and titanium alloy (Ti-6Al-4V ELI per ASTM F136) endplate components that orient into predetermined lordotic angles of 0, 8 and 12 degrees. The expandable implants are available in 7 to 14mm heights, an 11mm width, and 25, 30 and 35mm lengths. The subject Biomet Spine Fusion System implant is provided sterile only.

The provided document describes a 510(k) premarket notification for the Biomet Spine Fusion System, indicating it is a medical device submission to the FDA. The document focuses on demonstrating substantial equivalence to a predicate device, rather than proving the device meets specific acceptance criteria through a clinical study. Therefore, much of the requested information regarding acceptance criteria, study design, ground truth, and expert involvement is not present in this type of regulatory submission. The performance assessment here is primarily based on mechanical testing, not human reader performance or clinical outcomes.

Here's the information that can be extracted and a clear statement about what is not available based on the provided text:

1. A table of acceptance criteria and the reported device performance

The document does not provide a formal table of acceptance criteria with corresponding performance metrics in a clinical context. Instead, it states that:

2. Sample size used for the test set and the data provenance

• Sample Size for Test Set: Not applicable in the context of this mechanical testing study. The performance data refers to results from physical tests of the device components.
• Data Provenance: Not applicable. The data is generated from mechanical testing of the device components, not from patient data, and thus does not have a country of origin or a retrospective/prospective classification in the typical sense of a clinical study.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. Ground truth, in this context, would relate to clinical outcomes or expert diagnoses, which are not part of this mechanical testing. The "ground truth" for mechanical testing would be the established engineering specifications and performance limits of the predicate device.

4. Adjudication method for the test set

Not applicable. Adjudication methods are relevant for clinical trials or studies involving expert assessment, which is not described here.

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, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This submission is for a physical intervertebral body fusion device and does not involve AI or human image readers.

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

No, a standalone (algorithm-only) performance evaluation was not done. This device is a physical implant, not a software algorithm.

7. The type of ground truth used

For the mechanical testing, the "ground truth" is established by engineering safety and performance standards (e.g., ASTM F2077, ASTM F2267) and the performance specifications of the legally marketed predicate devices. The goal is to demonstrate that the new device's mechanical properties are equivalent to or better than those of the predicate.

8. The sample size for the training set

Not applicable. This is not a machine learning or AI device that would have a training set. The "training" in product development for such a device refers to engineering design and testing iterative processes, not data training.

9. How the ground truth for the training set was established

Not applicable, as there is no training set in the context of machine learning. The design and testing of the device are based on established engineering principles, material science, and regulatory guidance for spinal implants.

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