When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (Occiput-T3), the Ascent POCT System is indicated for: a) degenerative disc disease (defined as neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies); b) spondylolisthesis; c) fracture/dislocation; d) spinal stenosis; e) atlanto-axial fracture with instability: f) occipito-cervical dislocation; g) tumors; h) revision of previous cervical spine surgery. The occipital bone screws are limited to occipital fixation only. The use of the multi-axial screws is limited to placement in the upper thoracic spine (T1-T3) for the treatment of thoracic conditions only. They are not intended to be placed in the cervical spine. The lateral offset adapter is indicated for use in the upper thoracic spine (T1-T3). The hooks are intended to be placed from C1 to T3. The Songer Cable (titanium) System to be used with the Ascent Posterior Occipital Cervical Thoracic System allows for wire/cable attachment to the posterior cervical spine. The Ascent Posterior Occipital Cervical Thoracic System can also be linked to the Orthofix Spinal Fixation System using the Ascent Axial or Parallel Rod Connector.
Device Story
The Ascent POCT System is a temporary, non-sterile, single-use spinal fixation system used by surgeons to build implant constructs for immobilization and stabilization of the cervical and upper thoracic spine (Occiput-T3). Components include rods, setscrews, cross connectors, axial/parallel rod connectors, lateral offset adapters, multi-axial screws, hooks, bone screws, and Songer cables. The system can be linked to the Orthofix Spinal Fixation System. Surgeons assemble the construct intraoperatively to provide structural support during the fusion process. The device benefits patients by stabilizing spinal segments, facilitating fusion, and addressing instability or deformity. It is intended for use in clinical settings by trained orthopedic or neurosurgeons.
Clinical Evidence
Bench testing only. Mechanical performance was validated through static and dynamic compression bending and torsion testing in accordance with ASTM F2706-08 standards. No clinical data was required or provided.
Technological Characteristics
System components are constructed from Titanium Alloy (ASTM F136) and Cobalt Chrome Alloy (ASTM F1537). The system utilizes a modular rod-and-screw fixation design. It is non-sterile and intended for single use. No software or electronic components are involved.
Indications for Use
Indicated for patients requiring spinal fusion of the cervical spine and occipito-cervico-thoracic junction (Occiput-T3) due to degenerative disc disease, spondylolisthesis, fracture/dislocation, spinal stenosis, atlanto-axial fracture with instability, occipito-cervical dislocation, tumors, or revision of previous cervical spine surgery.
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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# 183
## MAY 2 4 2011
Premarket Notification 510(k) Orthofix Inc. Orthofix Ascent POCT System
#### 510(k) SUMMARY
### Orthofix Ascent POCT System
| Submitter Information | |
|----------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Name: | Orthofix Inc. |
| Address: | 3451 Plano Parkway<br>Lewisville, TX 75056 |
| Telephone Number: | 214.937.2000 |
| Fax Number: | 214.937.3322 |
| Email: | darlachew@orthofix.com |
| Registration Number: | 3008524126 |
| Contact Person: | Darla Chew<br>Director of Regulatory Affairs |
| Date Prepared: | April 26, 2011 |
| Name of Device | |
| Trade Name / Proprietary | Ascent® Posterior Occipital Cervical Thoracic (POCT) System |
| Common Name: | Spinal Fixation System |
| Product Code: | KWP – Spinal Interlaminal Fixation Orthosis |
| Regulatory Classification: | Class II – 888.3050 – Spinal Interlaminal Fixation Orthosis |
| Review Panel: | Orthopedic Device Panel |
| Predicate Devices: | Blackstone Posterior Cervical System, K030197, SE 6-12-03<br>Ascent POCT System, K080394, SE 3-13-08 (Plate and Rod Modifications)<br>Firebird Spinal Fixation System, Cobalt Chrome Rods, K092624, SE 9-25-2009 |
Reason for 510(k) Submission: New product offering
Orthofix inc., 3451 Plano Parkway, Lewisville, Texas 75056 | 214-937-2061 www.orthofix.com
Pg 1 of 4
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KIIII183
Premarket Notification 510(k) Orthofix Inc. Orthofix Ascent POCT System
#### Device Description
The Ascent® POCT System is a temporary, multiple component system comprised of a variety of non-sterile, single use components made of Titanium and Cobalt Chrome allov that allow the surgeon to build a spinal implant construct. The system design is intended to promote immobilization and stabilization of spinal segments as an adjunct to fusion of the cervical and for upper thoracic spine. Ascent POCT System consists of an assortment of rods, setscrews, cross connectors, axial connectors, lateral offset adapters, multi-axial screws, hooks, plates, bone screws, and Songer Cables. Ascent POCT system can also be linked to Orthofix Spinal Fixation System (SFS) using the Ascent Axial or Parallel Rod Connector or Transition Rods.
#### Intended Use / Indications for Use
When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (Occiput-T3), the Ascent POCT System is indicated for:
- a) degenerative disc disease (defined as neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies);
- b) spondylolisthesis;
- c) fracture/dislocation;
- d) spinal stenosis;
- e) atlanto-axial fracture with instability:
- f) occipito-cervical dislocation;
- g) tumors;
- h) revision of previous cervical spine surgery
The occipital bone screws are limited to occipital fixation only. The use of the multi-axial screws is limited to placement in the upper thoracic spine (T1-T3) for the treatment of thoracic conditions only. They are not intended to be placed in the cervical spine. The lateral offset adapter is indicated for use in the upper thoracic spine (T1-T3). The hooks are intended to be placed from C1 to T3. The Songer Cable (titanium) System to be used with the Ascent Posterior Occipital Cervical Thoracic System allows for wire/cable attachment to the posterior cervical spine.
The Ascent Posterior Occipital Cervical Thoracic System can also be linked to the Orthofix Spinal Fixation System using the Ascent Axial or Parallel Rod Connector.
> Orthofix inc., 3451 Plano Parkway, Lewisville, Texas 75056 | 214-937-2061 www.orthofix.com
Page 2 of 4
{2}------------------------------------------------
Image /page/2/Picture/0 description: The image shows the text "Premarket Notification 510(k)" at the top, followed by "Orthofix Inc." and "Orthofix Ascent POCT System" below. The text is arranged in a centered format. The image appears to be a snippet from a document or presentation.
#### Summary of the Technological Characteristics of the Device Compared to the Predicate Device
| Characteristic | Orthofix Ascent Rods | Ascent POCT System<br>(K030197 & K080394) | Firebird Spinal<br>Fixation System,<br>Cobalt Chrome Rods<br>(K092624) |
|-------------------|-------------------------------------------------------------------|-------------------------------------------------------------------|------------------------------------------------------------------------|
| Function / Design | This system allows a surgeon to build a spinal implant construct. | This system allows a surgeon to build a spinal implant construct. | This system allows a surgeon to build a spinal implant construct. |
| Rod Configuration | Straight & Occipital | Straight & Occipital | Straight |
| Rod Sizes | Straight: 3.0 mm x 70, 120, 200 mm long; Occipital Rod | Straight: 3.0 mm x 70, 120, 200 mm long; Occipital Rod | Not relevant |
| Material | 1) Cobalt Chrome Alloy, ASTM F1537<br>2) Titanium Alloy ASTM F136 | Titanium Alloy ASTM F136 | Cobalt Chrome Alloy, ASTM F1537 |
#### PERFORMANCE DATA - Summary of Non-Clinical Test Conducted for Determination of Substantial Equivalence
| Characteristic | Standard / Test/ FDA Guidance |
|----------------------------------|-------------------------------|
| Static Compression Bending Test | ASTM F2706-08 |
| Static Torsion Test | ASTM F2706-08 |
| Dynamic Compression Bending Test | ASTM F2706-08 |
| Dynamic Torsion Test | ASTM F2706-08 |
#### Performance Data Summary
Mechanical testing of the Orthofix Ascent POCT System was conducted in accordance to ASTM F2706-08 standard for Static & Dvnamic Compression Bending test and ASTM F2706-08 standards for Static & Dynamic Torsion test. Test results demonstrated that the new, proposed Ascent rods are substantially equivalent to predicate devices that have the same intended use, similar indications, technological characteristics and principles of operation.
#### Substantial Equivalence
The Orthofix proposed Ascent rods are substantially equivalent in design, function, and intended use to the Orthofix Ascent POCT system rods. The original Ascent POCT System received 510(k) clearance under K030197 on June 12, 2003 with subsequent changes to the Ascent Occipital rod under K080394 SE March 13, 2008.
The Orthofix proposed Ascent rods are substantially equivalent in material composition to Firebird Spinal Fixation System, Cobalt Chrome Rods 510(k) K092624 (SE 9-25-2009).
> Orthofix inc., 3451 Plano Parkway, Lewisville, Texas 75056 | 214-937-2061 www.orthofix.com
Pg 3 of 4
Page 3 of 4
{3}------------------------------------------------
KIIII183
Premarket Notification 510(k) Orthofix Inc. Orthofix Ascent POCT System
The difference between the modified rods and the predicate devices consist of minor dimensional changes for the Ascent Occipital rod, and the addition of Cobalt Chrome rods. Based on test results, these changes do not present any new / additional issues of safety or effectiveness therefore; the Orthofix proposed Ascent rods (part of the Ascent POCT System) are substantially equivalent to the predicate devices.
> Orthofix inc., 3451 Plano Parkway, Lewisville, Texas 75056 | 214-937-2061 www.orthofix.com
> > Page 4 of 4
Rs 4 of 4
{4}------------------------------------------------
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Orthofix, Inc. % Ms. Darla Chew - - -Director of Regulatory Affairs 3451 Plano Parkway Lewisville, TX 75056
MAY 2 4 2011
Re: K111183
Trade/Device Name: Ascent Posterior Occipital Cervical Thoracic System (Titanium &
Cobalt Chrome Rods) Regulation Number: 21 CFR 888.3050 Regulation Name: Spinal interlaminal fixation orthosis Regulatory Class: Class II Product Code: K WP Dated: April 26, 2011 Received: April 27, 2011
Dear Ms. Chew:
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 note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
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
{5}------------------------------------------------
#### Page 2 - Ms. Darla Chew
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.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 go to
http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
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 (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.
Sincerely yours,
E.S. Keith
2 Mark N. Melkerson Director Division of Surgical, Orthopedic And Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{6}------------------------------------------------
#### INDICATION FOR USE STATEMENT
#### 510(k) Number (if known): K111183
Device Name: Ascent Posterior Occipital Cervical Thoracic (POCT) System (Titanium & Cobalt Chrome Rods)
#### Indications for Use:
When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (Occiput-T3), the Ascent POCT System is indicated for:
- a. degenerative disc disease (defined as neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radiographic studies);
- b. spondvlolisthesis;
- c. fracture/dislocation;
- d. spinal stenosis;
- e. atlanto-axial fracture with instability;
- f. occipito-cervical dislocation;
- g. tumors;
- h. revision of previous cervical spine surgery
The occipital bone screws are limited to occipital fixation only. The use of the multi-axial screws is limited to placement in the upper thoracic spine (T1-T3) for the treatment of thoracic conditions only. They are not intended to be placed in the cervical spine. The lateral offset adapter is indicated for use in the upper thoracic spine (T1-T3). The hooks are intended to be placed from C1 to T3. The Songer Cable (titanium) System to be used with the Ascent Posterior Occipital Cervical Thoracic System allows for wire/cable attachment to the posterior cervical spine.
The Ascent Posterior Occipital Cervical Thoracic System can also be linked to the Orthofix Spinal Fixation System using the Ascent Axial or Parallel Rod Connector.
Prescription Use: X (Part 21 CFR 801 Subpart D) And / Or
Over-The-Counter (Part 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)
(Div/sion Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices
510(k) Number_________________________________________________________________________________________________________________________________________________________________ K ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! www.orthofix.com
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Learn the FDA Browser
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
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.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
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.
6. Collections
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.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
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.
8. Chart view
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.