K112709 · Nu Vasive, Incorporated · ETN · Feb 9, 2012 · Ear, Nose, Throat
Device Facts
Record ID
K112709
Device Name
STIMULATION/DISSECTION INSTRUMENTS
Applicant
Nu Vasive, Incorporated
Product Code
ETN · Ear, Nose, Throat
Decision Date
Feb 9, 2012
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 874.1820
Device Class
Class 2
Indications for Use
The Stimulation/Dissection Instruments are indicated for tissue dissection and stimulation of peripheral motor nerves for location and identification during surgery, including spinal nerve roots.
Device Story
NuVasive Stimulation/Dissection Instruments are manual surgical tools including retractors, dilators, stimulating electrodes, taps, drills, probes, needles, and screwdrivers. Devices feature proximal connectors for attachment to a monopolar stimulator and insulating sheaths for electrical safety. Distal surfaces are non-insulated to allow for mechanical tissue dissection, resection, probing, and nerve stimulation. Used by surgeons during surgical procedures to locate and identify peripheral motor nerves, including spinal nerve roots. The device facilitates nerve identification by delivering electrical stimulation to tissues, helping the surgeon avoid nerve damage during dissection. Some instruments are provided sterile for single use, while others are reusable and non-sterile.
Clinical Evidence
Bench testing only. No clinical data provided. Testing included stimulation and insulation impedance, current density determination, biocompatibility per ISO 10993-1, and sterilization validation per ISO 11135-1.
Technological Characteristics
Manual surgical instruments (retractors, dilators, electrodes, etc.). Materials: Anodized Aluminum, Stainless Steel, Radel. Biocompatible. Electrical insulation provided via sheaths or accessories. Sterilization: Sterile for single use or non-sterile reusable. Energy: Monopolar electrical stimulation. Connectivity: Proximal connector for external stimulator.
Indications for Use
Indicated for tissue dissection and stimulation of peripheral motor nerves for location and identification during surgery, including spinal nerve roots.
Regulatory Classification
Identification
A surgical nerve stimulator/locator is a device that is intended to provide electrical stimulation to the body to locate and identify nerves and to test their excitability.
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Image /page/0/Picture/0 description: The image shows the logo for Nuvasive. The logo consists of a stylized, incomplete circle on the left, followed by the word "NUVASIVE" in capital letters. Below the word "NUVASIVE" is the tagline "Speed of Innovation" in a smaller font.
# 510(k) Summary
In accordance with Title 21 of the Code of Federal Regulations. Part 807, and in particular 21 CFR §807.92. the following summary of information is provided:
## Submitted by: A.
Elias Ketchum Senior Associate. Regulatory Affairs NuVasive, Incorporated 7475 Lusk Blvd. San Diego, California 92121 Contact: (858) 320-4588
Date Prepared: September 2, 2011
## B. Device Name
| Trade or Proprietary Name: | <i>NuVasive</i> ® Stimulation/Dissection Instrument |
|----------------------------|-----------------------------------------------------|
| Common or Usual Name: | Nerve Stimulator/Locator |
| Classification Name: | Surgical Nerve Stimulator/Locator |
| Device Class: | Class II |
|-----------------|-------------------|
| Classification: | 21 CFR § 874.1820 |
| Product Code: | ETN |
## C. Predicate Devices
The subject Stimulation/Dissection Instruments are substantially equivalent to the following predicate devices currently distributed commercially in the U.S .:
- K031003 Medtronic Stimulation/Dissection Instruments �
- K111597 NuVasive Disposable Stimulating Electrode .
## D. Device Description
The NuVasive Stimulation/Dissection Instruments are similar to existing Class I exempt manual surgical instruments described in 21 CFR 88.4540 Orthopedic Manual Surgical Instruments. The instruments consist of retractors, dilators (expanding set of cannula), a stimulating electrode, taps, drills, probes, needles, and screw drivers with proximal connectors to attach the instruments to a monopolar stimulator, and insulating sheaths to provide biocompatible electrical insulation to selected portions of the instruments. The distal surfaces of the instruments are selectively noninsulated and manufactured from durable biocompatible materials to provide for mechanical, manual dissection/resection, probing, and tissue stimulation.
## E. Intended Use
The Stimulation/Dissection Instruments are indicated for tissue dissection and stimulation of peripheral motor nerves for location and identification during surgery, including spinal nerve roots.
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# hnological Characterist ت
wa established in this subject Similation Instruments are substantaly equivalent to ol
dicate devices de the PDA for commercial distribution in the subject device was shown a
| Predicate Device | | Subject Device | Substantially<br>Equivalent |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------|
| Stimulation/Dissection Instruments<br>K031003 | | NuVasive® Stimulation/Dissection Instruments<br>K112709 | |
| The Stimulation/Dissection Instruments are<br>indicated for tissue dissection and stimulation of<br>cranial and peripheral motor nerves for location<br>and identification during surgery, including<br>spinal nerve roots. | | The Stimulation/Dissection Instruments are indicated<br>for tissue dissection and stimulation of peripheral<br>motor nerves for location and identification during<br>surgery, including spinal nerve roots. | Yes |
| ETN | | ETN | Yes |
| 874.1820 | | 874.1820 | Yes |
| Electrical insulation on all surfaces not intended<br>to provide electrical contact with the patient and<br>connection | | Some instruments have electrical insulation on surfaces<br>not intended to provide electrical contact with the<br>patient and connection while others are used with an<br>insulating accessory that provides electrical insulation<br>on surfaces not intended to provide electrical contact<br>with the patient and connection. | Yes |
| Yes | | Yes | Yes |
| Biocompatible | | Biocompatible:<br>Anodized Aluminum<br>Stainless Steel<br>Radel | Yes |
| Sterile for single use | | Some instruments are provided sterile for single use<br>only while others are provided as non-sterile reusable<br>instruments. | Yes |
# Predicate and Subject Device Comparison 1
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Image /page/2/Picture/0 description: The image shows the logo for Nuvasive. The logo consists of a stylized, incomplete circle on the left, followed by the word "NUVASIVE" in a sans-serif font. Below the word "NUVASIVE" is the tagline "Speed of Innovation" in a smaller font.
## G. Performance Data
Nonclinical testing was performed to demonstrate that the subject Stimulation/Dissection Instruments are substantially equivalent to other predicate devices. The following testing was performed:
- . Stimulation and Insulation Impedance
- . Current Density Determination
- . Biocompatibility testing per ISO 10993-1
- . Sterilization validation per ISO 11135-1
The results of these studies showed that the subject Stimulation/Dissection Instruments meets or exceeds the performance of the predicate device, and the device was therefore found to be substantially equivalent.
## Conclusions H.
Based on the indications for use, technological characteristics, performance testing, and comparison to predicate devices, the subject Stimulation/Dissection Instruments has been shown to be substantially equivalent to legally marketed predicate devices, and do not raise new questions of safety or effectiveness.
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Image /page/3/Picture/0 description: The image is a logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines forming its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged in a circular fashion around the bird-like figure.
# DEPARTMENT OF HEALTH & HUMAN SERVICES
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
NuVasive, Inc. c/o Mr. Elias Ketchum Senior Associate, Regulatory Affairs 7475 Lusk Blvd. San Diego, California 92121
FEB - 9 2012
Re: K112709
Trade/Device Name: NuVasive Stimulation/Dissection Instruments Regulation Number: 21 CFR 874.1820 Regulation Name: Nerve Stimulator/Locator Regulatory Class: Class II Product Code: ETN Dated: January 6, 2012 Received: January 9, 2012
Dear Mr. Ketchum:
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.
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# Page 2 - Mr. Elias Ketchum
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); good manufacturing practice requirements as set forth in the quality systems (OS) 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/ReportaProblem/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/ResourcesforYou/Industry/default.htm.
Sincerely vours.
signature
Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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K112709
# Indications for Use
510(k) Number (if known): K112709
Device Name: NuVasive® Stimulation and Dissection Instruments
Indications For Use:
The Stimulation/Dissection Instruments are indicated for tissue dissection and stimulation of peripheral motor nerves for location and identification during surgery, including spinal nerve roots.
Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
R. Mathe
(Division Sign-Off) Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices
| 510(k) Number | K112709 |
|---------------|---------|
|---------------|---------|
Prescription Use (Per 21 CFR 801.109)
Page 1 of 1
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.