K211845 · Southern Spine, LLC · MAX · Nov 16, 2021 · Orthopedic
Device Facts
Record ID
K211845
Device Name
Deploy Expandable Interbody System
Applicant
Southern Spine, LLC
Product Code
MAX · Orthopedic
Decision Date
Nov 16, 2021
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 888.3080
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
The Deploy™ Expandable Interbody System implants are intervertebral body fusion devices indicated for use with autograft and/or allogenic bone graft comprised of carcellous bone graft when used as an adjunct to fusion in patients with degenerative disease (DDD) at one level or two contiguous levels of the lumbar spine (L2-S1). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. DDD patients may also have up to Grade I spondylolisthesis at the involved levels. These patients should be skeletally mature and have at least six months of non-operative treatment prior to being treated with this system. Additionally, the Deploy™ implants can be used as an adjunct to fusion in patients diagnosed with degenerative scoliosis. Deploy™ implants are intended to be used with supplemental spinal fixation systems that are cleared for use in the lumbosacral spine.
Device Story
Deploy™ Expandable Interbody System consists of titanium alloy interbody cages and surgical instruments; used for lumbar intervertebral body fusion. Surgeon selects implant size using trial instruments; implant inserted into disc space and rotated in-situ to provide fixation and deploy graft containment arm. Ridges on superior/inferior surfaces contact endplates to resist expulsion. Used in conjunction with supplemental spinal fixation systems. Benefits include stabilization of spinal segments in patients with DDD or degenerative scoliosis. Provided non-sterile; requires sterilization by healthcare facility.
Clinical Evidence
Bench testing only. Testing included static axial compression, static compressive shear, dynamic axial compression, dynamic compressive shear (ASTM F2077), static subsidence (ASTM F2267), and wear debris testing (ASTM F1877). Biocompatibility assessment performed per ISO 10993-1.
Indicated for skeletally mature patients with degenerative disc disease (DDD) at one or two contiguous lumbar levels (L2-S1) or degenerative scoliosis. DDD defined as discogenic back pain with radiographic degeneration; may include up to Grade I spondylolisthesis or retrolisthesis. Requires six months of prior non-operative treatment. Must be used with autograft/allogenic bone graft and supplemental spinal fixation.
Regulatory Classification
Identification
An intervertebral body fusion device is an implanted single or multiple component spinal device made from a variety of materials, including titanium and polymers. The device is inserted into the intervertebral body space of the cervical or lumbosacral spine, and is intended for intervertebral body fusion.
Special Controls
*Classification.* (1) Class II (special controls) for intervertebral body fusion devices that contain bone grafting material. The special control is the FDA guidance document entitled “Class II Special Controls Guidance Document: Intervertebral Body Fusion Device.” See § 888.1(e) for the availability of this guidance document.(2) Class III (premarket approval) for intervertebral body fusion devices that include any therapeutic biologic (e.g., bone morphogenic protein). Intervertebral body fusion devices that contain any therapeutic biologic require premarket approval.
(c)
*Date premarket approval application (PMA) or notice of product development protocol (PDP) is required.* Devices described in paragraph (b)(2) of this section shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.
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November 16, 2021
Southern Spine LLC % Julie Stephens President/Consultant Regulatory Resources Group, Inc. 111 Laurel Ridge Dr Alpharetta, Georgia 30004
Re: K211845
Trade/Device Name: Deploy™ Expandable Interbody System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: MAX Dated: July 21, 2021 Received: July 22, 2021
Dear Ms. Stephens:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.
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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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely.
Brent Showalter, Ph.D. Assistant Director DHT6B: Division of Spinal Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
# 510(k) Number (if known)
K211845
Device Name Deploy™ Expandable Interbody System
#### Indications for Use (Describe)
The Deploy™ Expandable Interbody System implants are intervertebral body fusion devices indicated for use with autograft and/or allogenic bone graft comprised of carcellous bone graft when used as an adjunct to fusion in patients with degenerative disease (DDD) at one level or two contiguous levels of the lumbar spine (L2-S1). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. DDD patients may also have up to Grade I spondylolisthesis at the involved levels. These patients should be skeletally mature and have at least six months of non-operative treatment prior to being treated with this system. Additionally, the Deploy™ implants can be used as an adjunct to fusion in patients diagnosed with degenerative scoliosis. Deploy™ implants are intended to be used with supplemental spinal fixation systems that are cleared for use in the lumbosacral spine.
Type of Use (Select one or both, as applicable)X Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
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## Southern Spine LLC Traditional 510(k): K211845 - Deploy™ Expandable Interbody System
# 510(k) Summary
This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements under 21 CFR 807.92.
| Submitted By: | Southern Spine LLC<br>487 Cherry Street – Third Street Tower<br>Macon, GA 31201<br>Phone: (478) 745-0000 |
|-----------------|----------------------------------------------------------------------------------------------------------|
| Contact Person: | Julie Stephens, President/Consultant<br>Regulatory Resources Group, Inc. - Phone: (678) 513-0693 |
| Date Submitted: | November 12, 2021 |
Device Name and Classification:
| Trade/Proprietary Name: | Deploy™ Expandable Interbody System |
|-------------------------|------------------------------------------------------|
| Common Name: | Intervertebral body fusion device |
| Regulation Number: | 21 CFR 888.3080 |
| Regulation Name: | Intervertebral fusion device with bone graft, lumbar |
| Class: | II |
| Product Code: | MAX |
#### Legally Marketed Predicate Devices:
Primary Predicate: Amendia Interbody Fusion Devices [Zeus] - 510(k) # K151322 Additional Predicate: MOJAVE Expandable Interbody System - 510(k) # K163364 and K171097 Additional Predicate: Synthes OPAL Spacer/Cage - 510(k) # K072791
None of the predicates have been subject to a design-related recall.
#### Device Description:
The Deploy™ Expandable Interbody System is comprised of the interbody implant cages, surgical instruments which include trial instruments to aid in the selection of the appropriate implant size for the patient's anatomy, and sterilization trays. The implants are manufactured from titanium alloy Ti-6AI-4V (ASTM F136, ASTM F3001) and are offered with various heights and shapes for different patient anatomy. Each implant is designed to be inserted and then rotate in-situ, providing immediate fixation and the arm deployed for the graft containment area. Ridges on the superior and inferior surfaces of the titanium implants contact the endplates to resist expulsion forces. The implants are designed to be used in conjunction with supplemental spinal fixation instrumentation. The surgical instruments are manufactured from stainless steel (ASTM F899. ISO 7153-1). The implants and surgical instruments are provided non-sterile and require sterilization prior to use within sterilization trays following validated sterilization parameters as provided within the Instructions for Use.
#### Indications for Use:
The Deploy™ Expandable Interbody System implants are intervertebral body fusion devices indicated for use with autograft and/or allogenic bone graft comprised of cancellous and/or corticocancellous bone graft when used as an adjunct to fusion in patients with degenerative
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# Southern Spine LLC Traditional 510(k): K211845 - Deploy™ Expandable Interbody System
# 510(k) Summarv
disc disease (DDD) at one level or two contiguous levels of the lumbar spine (L2-S1). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. DDD patients may also have up to Grade I spondvlolisthesis or retrolisthesis at the involved levels. These patients should be skeletally mature and have at least six months of non-operative treatment prior to being treated with this system. Additionally, the Deploy™ implants can be used as an adjunct to fusion in patients diagnosed with degenerative scoliosis. Deploy™ implants are intended to be used with supplemental spinal fixation systems that are cleared for use in the lumbosacral spine.
#### Technological Characteristics:
The Deploy™ Expandable Interbody System and the predicate devices have the same principles of operation as interbody fusion devices in patients at one level or two contiquous levels from L2 to S1. The Deploy™ Expandable Interbody System have the same or similar technological characteristics as its predicate devices through comparison of characteristics including design, intended use, material composition, and function. The proposed implants are classified as permanent implants (more than 30 days), single patient use only, and have validated instructions for cleaning and sterilization.
#### Summary of Testing:
The biocompatibility risk assessment was completed as directed by FDA guidance under ISO 10993-1 and Parts 5 biocompatibility requirements. Cytotoxicity testing was completed to demonstrate and support justification that the known biocompatible materials, Titanium Alloy (Ti6Al4V ELI) per ASTM F136 and ASTM 3001 standards, maintained compliance through manufacturing processes and cleaning and sterilization validated for the final implants and instruments. The Deploy™ Expandable Interbody System was tested in static axial compression (ASTM F2077), static compressive shear (ASTM F2077), dynamic axial compression (ASTM F2077), dynamic compressive shear (ASTM F2077), static subsidence (ASTM F2267), and wear debris testing (ASTM F1877).
#### Substantial Equivalence Conclusions:
Deploy™ Expandable Interbody System was shown to be substantially equivalent to predicate systems in terms of indications for use, design, function, material composition, range of sizes, and mechanical performance.
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