Synthes Synapse System is indicated for the following: Hooks, Plate/Rods, Plates, Rods and Screws When intended to promote fusion of the cervical spine and occipitocervical junction (occiput-T3), the plate/rod, plates, rod, hook and screw (3.2 mm cortex) components of the Synthes Cervifix, Axon, OC Fusion and Synapse Systems are indicated for the following: • Degenerative Disc Disease (DDD) (defined as neck pain of discogenic origin with degeneration of the disc as confirmed by patient history and radiographic studies) • Spondylolisthesis • Spinal Stenosis • Fracture/dislocation • Atlantoaxial fracture with instability • Occipitocervical dislocation • Revision of previous cervical spine surgery • Tumor When used to treat these cervical and occipitocervical conditions, screws are limited to occipital fixation only. Hooks and Rods The rod and hook components are also intended to provide stabilization to promote fusion following reduction of fracture/dislocation or trauma in the cervical/upper thoracic (C1-T3) spine. Rods, Clamps, Screws, Nuts, Variable Axis Screws, Locking Screws, and Transverse Bars The rods, clamps, screws, nuts, variable axis screws, locking screws, and transverse bars are intended to promote fusion following reduction of fracture/dislocation or trauma in the upper thoracic spine (T1-T3). The use of these screws (3.5 mm, 4.0 mm and 4.5 mm cancellous, and 3.5 mm and 4.2 mm cortex) is limited to placement in T1-T3 in treating thoracic conditions only. They are not intended to be placed in or treat conditions involving the cervical spine. The Synthes CerviFix, Axon, and Synapse Systems can also be linked to the Synthes Universal Spinal System using the 3.5 mm/6.0 mm parallel connectors from that system and via the CerviFix tapered rods using lamina hooks, transverse process hooks, pedicle hooks, 4.2 mm screws and the 5.0 mm/6.0 mm parallel connector. Warning: This device is not intended for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic (T4-T12), or lumbar spine.
Device Story
Synthes Synapse Transconnector is a top-loading rigid link designed for placement over two mono-segmental variable axis screws to cover exposed spinal cord following laminectomy. Device acts as a bridge between longitudinal rods within the Synthes Synapse System. Used in surgical settings by physicians to provide spinal stabilization and promote fusion. Benefits include structural support for the posterior cervical/thoracic spine. Device is a line extension of the Synapse System and a modification of the Cervifix transconnector.
Clinical Evidence
Bench testing only; no clinical data required or provided.
Technological Characteristics
Manufactured from Titanium Aluminum Niobium (TAN) per ASTM F1295. Top-loading transconnector design for rigid linkage of longitudinal rods. Compatible exclusively with Synthes Synapse System components.
Indications for Use
Indicated for patients requiring spinal fusion in the cervical spine and occipitocervical junction (occiput-T3) or upper thoracic spine (T1-T3) due to DDD, spondylolisthesis, spinal stenosis, fracture/dislocation, instability, or tumor. Contraindicated for screw attachment/fixation to posterior elements (pedicles) of cervical, thoracic (T4-T12), or lumbar spine.
Regulatory Classification
Identification
A spinal interlaminal fixation orthosis is a device intended to be implanted made of an alloy, such as stainless steel, that consists of various hooks and a posteriorly placed compression or distraction rod. The device is implanted, usually across three adjacent vertebrae, to straighten and immobilize the spine to allow bone grafts to unite and fuse the vertebrae together. The device is used primarily in the treatment of scoliosis (a lateral curvature of the spine), but it also may be used in the treatment of fracture or dislocation of the spine, grades 3 and 4 of spondylolisthesis (a dislocation of the spinal column), and lower back syndrome.
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K090549 page 1 of 2
MAY 2 1 2009
# 10 510(k) Summary
| Name of Firm: | Synthes Spine<br>1302 Wrights Lane East<br>West Chester, PA 19380 |
|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Contact: | Stacey Bonnell<br>Regulatory Affairs Specialist<br>Telephone: 610-719-5895 Facsimile: 610-719-5102<br>Email: bonnell.stacey@synthes.com |
| Date Prepared: | February 27, 2009 |
| Trade Name: | Synthes Synapse Transconnector |
| Common Name: | Posterior Cervical System |
| Classification: | 21 CFR 888.3050 Appliance, Fixation, Spinal Interlaminal<br>Class II; Orthopaedic and Rehabilitation Devices Panel<br>Product Code: KWP |
| Predicate Device: | Synthes Synapse System (K072434 & K070573)<br>Synthes Cervifix (K011969) |
| Device Description: | The Synthes Synapse Transconnector is a top-loading transconnector<br>placed on top of two mono-segmental variable axis screws to cover the<br>exposed spinal cord following laminectomy. The Synthes Synapse<br>Transconnector is designed to be a rigid link between longitudinal rods,<br>and is compatible only with Synthes Synapse System.<br><br>The Synthes Synapse Transconnector is a line extension to Synthes<br>Synapse System, and a modification to the Synthes Cervifix<br>transconnector.<br><br>The implants are manufactured from Titanium Aluminum Niobium<br>TAN (Ti-6Al-7Nb) ASTM F1295, the same as the predicate device. |
| Intended Use /<br>Indications for Use: | Synthes Synapse System is indicated for the following:<br>Hooks, Plate/Rods, Plates, Rods and Screws<br>When intended to promote fusion of the cervical spine and<br>occipitocervical junction (occiput-T3), the plate/rod, plates, rod, hook<br>and screw (3.2 mm cortex) components of the Synthes Cervifix, Axon,<br>OC Fusion and Synapse Systems are indicated for the following:<br>• Degenerative Disc Disease (DDD) (defined as neck pain of<br>discogenic origin with degeneration of the disc as confirmed by<br>patient history and radiographic studies)<br>• Spondylolisthesis<br>• Spinal Stenosis<br>• Fracture/dislocation<br>• Atlantoaxial fracture with instability<br>• Occipitocervical dislocation<br>• Revision of previous cervical spine surgery<br>• Tumor<br><br>When used to treat these cervical and occipitocervical conditions,<br>screws are limited to occipital fixation only.<br> |
| | Hooks and Rods<br>The rod and hook components are also intended to provide stabilization |
| | to promote fusion following reduction of fracture/dislocation or trauma<br>in the cervical/upper thoracic (C1-T3) spine. |
| | <i>Rods, Clamps, Screws, Nuts, Variable Axis Screws, Locking Screws, and Transverse Bars</i> |
| | The rods, clamps, screws, nuts, variable axis screws, locking screws,<br>and transverse bars are intended to promote fusion following reduction<br>of fracture/dislocation or trauma in the upper thoracic spine (T1-T3). |
| | The use of these screws (3.5 mm, 4.0 mm and 4.5 mm cancellous, and<br>3.5 mm and 4.2 mm cortex) is limited to placement in T1-T3 in treating<br>thoracic conditions only. They are not intended to be placed in or treat<br>conditions involving the cervical spine. |
| | The Synthes CerviFix, Axon, and Synapse Systems can also be linked<br>to the Synthes Universal Spinal System using the 3.5 mm/6.0 mm<br>parallel connectors from that system and via the CerviFix tapered rods<br>using lamina hooks, transverse process hooks, pedicle hooks, 4.2 mm<br>screws and the 5.0 mm/6.0 mm parallel connector. |
| | Warning: This device is not intended for screw attachment or fixation<br>to the posterior elements (pedicles) of the cervical, thoracic (T4-T12),<br>or lumbar spine. |
| Comparison of the<br>technological<br>characteristics of the<br>device to the<br>predicate device: | The Synthes Synapse Transconnector is a result of design modifications<br>to the predicate device. Synthes has established that it is substantially<br>equivalent to the predicates in design, function, material, and intended<br>use. |
| Performance Data<br>(Nonclinical and/or<br>Clinical) | Non-Clinical Performance and Conclusions:<br>Bench testing results demonstrate that the Synthes Synapse System is<br>substantially equivalent to the predicate device. |
| | Clinical Performance and Conclusions:<br>Clinical data and conclusions were not needed for this device. |
....
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Page 2 of 2
Special 510(k) - Synthes Synapse Transconnector
Page 13 of 34
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird-like symbol on the right side. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES. USA" is arranged in a circular fashion around the symbol.
MAY 21 2009
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Public Health Service
Synthes Spine % Ms. Stacey Bonnell Regulatory Affairs Specialist 1302 Wrights Lane East West Chester, Pennsylvania 19380
Re: K090549
Trade/Device Name: Synthes Synapse System Regulation Number: 21 CFR 888.3050 Regulation Name: Spinal interlaminal fixation orthosis Regulatory Class: II Product Code: KWP Dated: April 20, 2009 Received: April 21, 2009
Dear Ms. Bonnell:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA), You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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Page 2 - Ms. Stacey Bonnell
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/.
You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours,
Howard W. Epps
fx
Mark N. Melkerson Director Division of Surgical, Orthopedic, and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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page 1 of 2
#### Indications for Use Statement 9
к 090549
510(k) Number: (if known)
### Device Name: Synthes Synapse
## Hooks, Plate/Rods, Plates, Rods and Screws
When intended to promote fusion of the cervical spine and occipitocervical junction (occiput-T3), the plate/rod, plates, rod, hook and screw (3.2 mm cortex) components of the Synthes Cervifix, Axon, OC Fusion and Synapse Systems are indicated for the following:
- · Degenerative Disc Disease (DDD) (defined as neck pain of discogenic origin with degeneration of the disc as confirmed by patient history and radiographic studies)
- · Spondylolisthesis
- · Spinal Stenosis
- · Fracture/dislocation
- · Atlantoaxial fracture with instability
- · Occipitocervical dislocation
- · Revision of pervious cervical spine surgery
- · Tumor
When used to treat these cervical and occipitocervical conditions, screws are limited to occipital fixation only.
#### Hooks and Rods
The rod and hook components are also intended to provide stabilization to promote fusion following reduction of fracture/dislocation or trauma in the cervical/upper thoracic (C1-T3) spine.
# Rods, Clamps, Screws, Nuts, Variable Axis Screws, Locking Screws, & Transverse Bars
The rods, clamps, screws, nuts, variable axis screws, locking screws, and transverse bars are intended to promote fusion following reduction of fracture/dislocation or trauma in the upper thoracic spine (T1-T3).
The use of these screws (3.5 mm, 4.0 mm and 4.5 mm cancellous, and 3.5 mm and 4.2 mm cortex) is limited to placement in T1-T3 in treating thoracic conditions only. They are not intended to be placed in or treat conditions involving the cervical spine.
The Synthes CerviFix, Axon, and Synapse Systems can also be linked to the Synthes Universal Spinal System using the 3.5 mm/6.0 mm parallel connectors from that system and via the CerviFix tapered rods using lamina hooks, transverse
Special 510(k) - Synthes Synapse Transconnector
Page 10 of 34
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process hooks, pedicle hooks, 4.2 mm screws and the 5.0 mm/6.0 mm parallel connector.
Warning: This device is not intended for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic (T4-T12), or lumbar spine.
X Prescription Use (21 CFR 801 Subpart D) AND / OR
Over-the-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE -- CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Gmin Heis
for (Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices .
> K090549 510(k) Number.
Special 510(k) - Synthes Synapse Transconnector
Page 11 of 34
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1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
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Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
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With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
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7. Product codes and the regulations tree
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What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
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Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.