MODIFICATION TO SPINAL CONCEPTS BACFIX TI SPINAL FIXATION SYSTEM
K983260 · Spinal Concepts, Inc. · MNI · Oct 21, 1998 · Orthopedic
Device Facts
Record ID
K983260
Device Name
MODIFICATION TO SPINAL CONCEPTS BACFIX TI SPINAL FIXATION SYSTEM
Applicant
Spinal Concepts, Inc.
Product Code
MNI · Orthopedic
Decision Date
Oct 21, 1998
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 888.3070
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
The Spinal Concepts, Inc. BacFix™ ti Spinal Fixation System consists of a combination of components which include rods, hooks, locking wedges, screws and transverse connectors which are indicated to provide temporary stability of the thoracic, thoracolumbar or lumbar spine (T1-S1). When intended for pedicle screw fixation, implants are 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, lumbar and sacral spine: Degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor and failed previous fusion (pseudarthrosis). Levels of pedicle screw attachment for these indications range from T1 to the sacrum. In addition, when intended for pedicle screw fixation, implants are intended for treatment of severe spondylolisthesis (grades 3 and 4) of the vertebra in skeletally mature patients receiving fusion by autogenous bone graft having implants attached to the lumbar and sacral spine with removal of implants after the attainment of solid fusion. The levels of screw fixation for these indications range from L3 to the sacrum. When intended for non-pedicle, posterior screw fixation of the non-cervical spine, the indications are: Idiopathic scoliosis. Neuromuscular scoliosis/kyphoscoliosis with associated paralysis or spacticity. Scoliosis with deficient posterior elements such as that resulting from laminectomy or myelomeningocele. Spinal fractures (acute reduction or late deformity). Degenerative disc disease (back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies). Neoplastic disease. Spondylolisthesis. Spinal stenosis. Failed previous fusion.
Device Story
BacFix™ ti Spinal Fixation System; titanium spinal implant construct for temporary stabilization of thoracic, thoracolumbar, or lumbar spine. Components include rods (5.5/6.0mm), hooks, locking wedges, screws (5.0-8.0mm), and transverse connectors. Surgeon assembles components outside wound; wedges connect rods to anchors; three-point shear clamp instrument secures construct. Used in OR by orthopedic/spine surgeons. Provides rigid fixation to facilitate spinal fusion; implants removed after solid fusion for specific severe spondylolisthesis cases. Benefits patient by providing mechanical stability during bone healing.
Clinical Evidence
Bench testing only. Static and fatigue mechanical testing performed and compared to published data for existing hook, rod, and screw spinal fixation systems. Results demonstrate the device is capable of withstanding clinical loading and maintaining mechanical integrity.
Technological Characteristics
Materials: Ti-6Al-4V ELI (ASTM F-136), Ti-6Al-7Nb (ASTM F-1295), or unalloyed titanium (ASTM F-67). Components: rods, hooks, locking wedges, screws, transverse connectors. Fixation: three-point shear clamp mechanism. Sterilization: sterile or non-sterile (requires user sterilization to 10^-6 SAL).
Indications for Use
Indicated for skeletally mature patients requiring spinal immobilization/stabilization as an adjunct to fusion for acute/chronic instabilities or deformities of the thoracic, lumbar, and sacral spine (T1-S1). Includes degenerative spondylolisthesis, fracture, dislocation, scoliosis, kyphosis, spinal tumor, failed fusion, severe spondylolisthesis (grades 3-4), idiopathic/neuromuscular scoliosis, spinal stenosis, and degenerative disc disease.
Regulatory Classification
Identification
(1) Rigid pedicle screw systems are comprised of multiple components, made from a variety of materials that allow the surgeon to build an implant system to fit the patient's anatomical and physiological requirements. Such a spinal implant assembly consists of a combination of screws, longitudinal members (e.g., plates, rods including dual diameter rods, plate/rod combinations), transverse or cross connectors, and interconnection mechanisms (e.g., rod-to-rod connectors, offset connectors).(2) Semi-rigid systems are defined as systems that contain one or more of the following features (including but not limited to): Non-uniform longitudinal elements, or features that allow more motion or flexibility compared to rigid systems.
Special Controls
*Classification.* (1) Class II (special controls), when 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, lumbar, and sacral spine: severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra; degenerative spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply with the following special controls:(i) Compliance with material standards;
(ii) Compliance with mechanical testing standards;
(iii) Compliance with biocompatibility standards; and
(iv) Labeling that contains these two statements in addition to other appropriate labeling information:
“Warning: The safety and effectiveness of pedicle screw spinal systems have been established only for spinal conditions with significant mechanical instability or deformity requiring fusion with instrumentation. These conditions are significant mechanical instability or deformity of the thoracic, lumbar, and sacral spine secondary to severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra, degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and failed previous fusion (pseudarthrosis). The safety and effectiveness of these devices for any other conditions are unknown.”
“Precaution: The implantation of pedicle screw spinal systems should be performed only by experienced spinal surgeons with specific training in the use of this pedicle screw spinal system because this is a technically demanding procedure presenting a risk of serious injury to the patient.”
(2) Class II (special controls), when a rigid pedicle screw system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in the treatment of degenerative disc disease and spondylolisthesis other than either severe spondylolisthesis (grades 3 and 4) at L5-S1 or degenerative spondylolisthesis with objective evidence of neurologic impairment. These pedicle screw systems must comply with the following special controls:
(i) The design characteristics of the device, including engineering schematics, must ensure that the geometry and material composition are consistent with the intended use.
(ii) Non-clinical performance testing must demonstrate the mechanical function and durability of the implant.
(iii) Device components must be demonstrated to be biocompatible.
(iv) Validation testing must demonstrate the cleanliness and sterility of, or the ability to clean and sterilize, the device components and device-specific instruments.
(v) Labeling must include the following:
(A) A clear description of the technological features of the device including identification of device materials and the principles of device operation;
(B) Intended use and indications for use, including levels of fixation;
(C) Identification of magnetic resonance (MR) compatibility status;
(D) Cleaning and sterilization instructions for devices and instruments that are provided non-sterile to the end user; and
(E) Detailed instructions of each surgical step, including device removal.
(3) Class II (special controls), when a semi-rigid system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion for any indication. In addition to complying with the special controls in paragraphs (b)(2)(i) through (v) of this section, these pedicle screw systems must comply with the following special controls:
(i) Demonstration that clinical performance characteristics of the device support the intended use of the product, including assessment of fusion compared to a clinically acceptable fusion rate.
(ii) Semi-rigid systems marketed prior to the effective date of this reclassification must submit an amendment to their previously cleared premarket notification (510(k)) demonstrating compliance with the special controls in paragraphs (b)(2)(i) through (v) and paragraph (b)(3)(i) of this section.
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# OCT 2 1 1998
KG83260
## SUMMARY OF SAFETY AND EFFECTIVENESS BacFix™ ti Spinal Fixation System (K983260)
#### I. General Information
| Classification Name: | 87 Orthopedics |
|--------------------------------|---------------------------------------------------------------------------------------------------------|
| Common Name: | Appliance, Fixation, Spinal Interlaminal |
| Device Trade Name: | BacFix™ ti Spinal Fixation System |
| Classification Code: | This device has been placed in Class II by the<br>Orthopedics Panel. |
| Submitter's Name & Address: | Spinal Concepts, Inc.<br>8200 Cameron Road, Suite B-160<br>Austin, Texas 78754 U.S.A.<br>(512) 339-4800 |
| Establishment Registration No: | 1649384 |
| Contact Person: | Tema M. Augostino |
Director, Clinical and Regulatory Affairs
October 15, 1998 Summary Preparation Date:
#### II. Predicate Device
The Spinal Concepts, Inc. BacFix™ ti Spinal Fixation System claimed to be substantially equivalent in material, design, and function to the existing BacFix™ Spinal Fixation System and the Synthes Universal Spinal System.
#### III. Device Description
The Spinal Concepts, Inc. BacFix™ ti Spinal Fixation System consists of a combination of titanium components which include rods, hooks, locking wedges, screws and transverse connectors which are indicated to provide temporary stability of the thoracic, thoracolumbar or lumbar spine (TI-S1). The BacFix™ Spinal Fixation System consists of longitudinal members (spinal rods), in diameters of 5.5 and 6.0mm, in two hardnesses, and a variety of lengths; spinal anchor components, hooks and screws (mono-axial and multi-axial) of various diameters (5.0, 6.0, 7.0 and 8.0mm) and lengths; locking connectors (threaded wedge and nut or non-threaded wedge and locking clip) sized to fit the spinal rods; and a transverse connector assembly (link), also in various lengths. Hooks and screws may be placed at any position along the spinal rods. Wedges are used to connect the spinal rods to screws (hooks and links). These components are preassembled outside the wound, eliminating the need to pre-plan the position of each eyebolt on the spinal rod. A spinal rod is positioned within the open face of the wedge. Fixation of the construct is accomplished using an instrument that applies a three point shear clamp. Addition of the hex nut (when using threaded wedge) and optional use of the
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locking clip (when using the non-threaded wedge) complete the implant. Anchor components may be added to (or removed from) the construct at any time during the procedure.
#### IV. Sterilization
The BacFix™ ti Spinal Fixation System implants and instrumentation may be provided sterile or non-sterile. Both implants and instruments must be sterilized prior to use in accordance with the recommended storilization parameters described in the package insert in order to achieve a sterility assurance level of 10-6.
#### V. Indications for Use
When intended for pedicle screw fixation, implants are 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, lumbar and sacral spine: Degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor and failed previous fusion (pseudarthrosis). Levels of pedicle screw attachment for these indications range from TI to the sacrum.
In addition, when intended for pedicle screw fixation, implants are intended for treatment of severe spondylolisthesis (grades 3 and 4) of the vertebra in skeletally mature patients receiving fusion by autogenous bone graft having implants attached to the lumbar and sacral spine with removal of implants after the attainment of solid fusion. The levels of screw fixation for these indications range from L3 to the sacrum.
When intended for non-pedicle, posterior screw fixation of the non-cervical spine, the indications are.
- Idiopathic scoliosis. ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
- in Neuromuscular scoliosis/kyphoscoliosis with associated paralysis or spacticity.
- Scoliosis with deficient posterior elements such as that resulting from laminectomy 3. or myelomeningocele.
- Spinal fractures (acute reduction or late deformity). ব
- Degenerative disc disease (back pain of discogenic origin with degeneration of the રું. disc confirmed by history and radiographic studies).
- 6. Neoplastic disease.
- 7. Spondylolisthesis.
- 8. Spinal stenosis.
- 9. Failed previous fusion.
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### Substantial Equivalence VT.
| Ti-6Al-4V ELI<br>(ASTM F-136)<br>or Ti-6AL-7Nb<br>(ASTM F-1295)<br>& unalloyed<br>titanuium<br>(ASTM F-67) | Rods (hard and soft<br>- various lengths)<br>Hooks (laminar,<br>pedicle, lumbar -<br>right and left),<br>Rod links/wedges<br>(various sizes and<br>lengths)<br>Screws (angled,<br>straight, various<br>sizes and<br>diameters) | Bilateral, dual<br>spinal rods<br>connected with<br>transverse rod<br>linkages.<br>Spinal rods are<br>attached to<br>thoracic &<br>lumbar spine<br>with hooks &<br>to sacral spine<br>with screws | When intended for pedicle screw<br>fixation, implants are intended to<br>provide immobilization and<br>stabilization of spinal segments in<br>skeletally mature patients as an<br>adjunct to fusion in the treatment of<br>the following acute and chronic<br>instabilities or deformities of the<br>thoracic, lumbar and sacral spine:<br>Degenerative spondylolisthesis with<br>objective evidence of neurologic<br>impairment, fracture, dislocation,<br>scoliosis, kyphosis, spinal tumor and<br>failed previous fusion<br>(pseudarthrosis). Levels of pedicle<br>screw attachment for these indications<br>range from T1 to the sacrum.<br>In addition, when intended for pedicle<br>screw fixation, implants are intended<br>for treatment of severe<br>spondylolisthesis (grades 3 and 4) of<br>the vertebra in skeletally mature<br>patients receiving fusion by<br>autogenous bone graft having implants<br>attached to the lumbar and sacral spine<br>with removal of implants after<br>attainment of solid fusion. The levels<br>of screw fixation for these indications<br>range from L3 to the sacrum.<br>When intended for non-pedicle,<br>posterior screw fixation of the non-<br>cervical spine, the indications are"<br>1. Idiopathic scoliosis, 2.<br>Neuromuscular scoliosis/<br>kyphoscoliosis with associated<br>paralysis or spacticity, 3. Scoliosis<br>with deficient posterior elements such<br>as that resulting from laminectomy or<br>myelomeningocele, 4. Spinal fractures<br>(acute reduction or late deformity), 5.<br>Degenerative disc disease (back pain<br>of discogenic origin with degeneration<br>of the disc confirmed by history and<br>radiographic studies), 6. Neoplastic<br>disease, 7. Spondylolisthesis, 8. Spinal<br>stenosis and 9. Failed previous fusion. |
|------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 316L Stainless<br>Steel & 22-13-5<br>Stainless Steel | Rods (hard and soft<br>- various sizes and<br>lengths)<br>Hooks (laminar,<br>pedicle, lumbar -<br>right and left),<br>Rod links/wedges<br>(various sizes and<br>lengths)<br>Screws (angled.<br>straight, various<br>sizes and<br>diameters) | Bilateral, dual<br>spinal rods<br>connected with<br>transverse rod<br>linkages.<br>Spinal rods are<br>attached to<br>thoracic &<br>lumbar spine<br>with hooks &<br>to sacral spine<br>with screws | Same as above |
| Ti-6AL-7NB &<br>CP (chemically<br>Pure) titanium | Rods (hard and<br>soft-various sizes<br>and lengths),<br>Hooks (laminar,<br>pedicle, lumbar.<br>transverse process),<br>rod collar,<br>transverse bars,<br>Screws (various<br>sizes and<br>diameters) | Bilateral, dual<br>spinal rods<br>connected with<br>transverse rod<br>linkages.<br>Spinal rods are<br>attached to<br>thoracic &<br>lumbar spine<br>with hooks &<br>to sacral spine<br>with screws | Intended for correction of anterolateral<br>lordotic deformities of the spine,<br>scoliosis, pseudarthrosis and fracture<br>or dislocation of the thoracolumbar<br>spine (T8-L5). |
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#### VII. Mechanical Testing
Static and fatigue testing was performed on the BacFix™ ti and the existing, BacFix™ Systems. These data were compared with published data of various other hook, rod and screw spinal fixation systems. The results of this testing demonstrated the BacFix™ ti to be substantially equivalent to the BacFix™ and the Synthes Universal Spine System and able to withstand clinical loading and maintain mechanical integrity.
#### VIII. Conclusion
The BacFix™ ti Spinal Fixation System is considered to be substantially equivalent in design, material and function to the existing BacFix™ System and the Synthes Universal Spine System.
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Image /page/4/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle or bird-like symbol with three curved lines forming its body and wings. The symbol is enclosed within a circular border, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is written around the border of the circle.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
OCT 21 1998
Ms. Teena M. Augostino Director, Regulatory and Clinical Affairs Spinal Concepts, Inc. 8200 Cameron Road, B-160 Austin, Texas 78754
K983260 Re:
BacFix™ ti Spinal Fixation System - expanded uses Regulatory Class: II Product Codes: MNI, KWP, and MNH Dated: September 11, 1998 Received: September 16, 1998
Dear Ms. Augostino:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we 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). 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.
If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
{5}------------------------------------------------
### Page 2 - Ms. Teena M. Augostino
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".
Sincerely yours,
Celia M. Witten, Ph.D., M.D.
Director
Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Page 1 of 1
K983260 510(k) Number (if known):
Spinal Concepts, Inc. BacFix™ ti Spinal Fixation System Device Name:
The Spinal Concepts, Inc. BacFix™ ti Spinal Fixation System consists of Indications for Use: a combination of components which include rods, hooks, locking wedges, screws and transverse connectors which are indicated to provide temporary stability of the thoracic, thoracolumbar or lumbar spine (T1-SI).
> When intended for pedicle screw fixation, implants are 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, lumbar and sacral spine: Degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor and failed previous fusion (pseudarthrosis). Levels of pedicle screw attachment for these indications range from T1 to the sacrum.
In addition, when intended for pedicle screw fixation, implants are intended for treatment of severe spondylolisihesis (grades 3 and 4) of the vertebra in skeletally mature patients receiving fusion by autogenous bone graft having implants attached to the lumbar and sacral spine with removal of implants after the attainment of solid fusion. The levels of screw fixation for these indications range from L3 to the sacrum.
When intended for non-pedicle, posterior screw fixation of the noncervical spine, the indications are:
- Idiopathic scoliosis. 】.
- associated Neuromuscular scoliosis/kyphoscoliosis with 2. paralysis or spacticity.
- Scoliosis with deficient posterior elements such as that resulting 3. from laminectomy or myelomeningocele.
- Spinal fractures (acute reduction or late deformity). ব .
- Degenerative disc disease (back pain of discogenic origin with ર : degeneration of the disc confirmed by history and radiographic studies).
- Neoplastic disease. ఈ
- Spondylolisthesis. 7.
- Spinal stenosis. 8.
- Failed previous fusion. 9.
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
| Prescription Use: | X |
|----------------------|---|
| (Per 21 CFR 801.109) | |
Concurrence of CDRH, Office of Device Evaluation (ODE)
| (Division Sign-Off) | |
|-----------------------------------------|--|
| Division of General Restorative Devices | |
| 510(k) Number | 1 <span style="text-decoration:overline;">K</span> 983260 |
|---------------|-----------------------------------------------------------|
|---------------|-----------------------------------------------------------|
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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.
