NuVasive® Modulus XLIF Interbody System

K172123 · Nu Vasive, Incorporated · MAX · Oct 11, 2017 · Orthopedic

Device Facts

• Record ID: K172123
• Device Name: NuVasive® Modulus XLIF Interbody System
• Applicant: Nu Vasive, Incorporated
• Product Code: MAX · Orthopedic
• Decision Date: Oct 11, 2017
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3080
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The NuVasive Modulus XLIF Interbody System is indicated for intervertebral body fusion of the spine in skeletally mature patients. The System is designed for use with autogenous and/or allogeneic bone graft comprised of cancellous and/or corticocancellous bone graft to facilitate fusion. When used with or without the Modulus XLIF internal fixation, the system is intended for use with supplemental spinal fixation systems cleared by the FDA for use in the thoracolumbar spine. The devices are to be used in patients who have had at least six months of non-operative treatment. The NuVasive Modulus XLIF Interbody System is intended for use in interbody fusions in the thoracolumbar spine from T1 to T12 and at the thoracolumbar junction (T12-L1), and for use in the lumbar spine from L1 to S1, for the treatment of symptomatic disc degeneration (DDD) or degenerative spondylolisthesis at one or two adjacent levels, including thoracy disc herniation (with myelopathy and/or radiculopathy with or without axial pain). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The NuVasive Modulus XLIF Interbody System can be used as an adjunct to fusion in patients diagnosed with multilevel degenerative scoliosis.

Device Story

Interbody fusion implant system; titanium alloy (Ti-6Al-4V ELI) construction; powder bed fusion manufacturing; solid and porous lattice structures; hollow core for bone graft packing; microporous textured surfaces for vertebral gripping; optional internal fixation plate with bone screws for migration resistance. Used by surgeons in spinal fusion procedures; implanted in thoracolumbar/lumbar spine; provides structural support and fusion site for bone graft; requires supplemental fixation. Benefits include stabilization of spinal segments and promotion of fusion in patients with degenerative disc disease or scoliosis.

Clinical Evidence

No clinical data. Bench testing only. Performed dynamic axial compression and dynamic torsion testing per ASTM F2077, and screw push-out analysis to validate the addition of the internal fixation component.

Technological Characteristics

Titanium alloy (Ti-6Al-4V ELI) per ASTM F3001; optional fixation plate/screws (Ti-6Al-4V ELI per ASTM F136/ISO 5832-3 and MP35N per ASTM F562). Powder bed fusion manufacturing. Microporous textured surfaces. No software or electrical components.

Indications for Use

Indicated for intervertebral body fusion in skeletally mature patients with symptomatic disc degeneration (DDD) or degenerative spondylolisthesis at 1-2 levels (T1-S1), including thoracic disc herniation. Also for multilevel degenerative scoliosis. Requires 6 months of failed non-operative treatment. Used with 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.

Predicate Devices

• Modulus XLIF Interbody System (K163230)
• CoRoent Thoracolumbar System (K170962)
• Lumbar Interbody Implants (K161230)
• CoRoent XL-F System (K140479)
• MLX - Medial Lateral Expandable Lumbar Interbody System (K153105)

Reference Devices

• ALIF Buttress Plate System (K143065)

Submission Summary (Full Text)

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NuVasive, Incorporated Cynthia Adams Sr. Specialist, Regulatory Affairs 7475 Lusk Blvd. San Diego, California 92121

October 11, 2017

# Re: K172123

Trade/Device Name: NuVasive® Modulus XLIF Interbody System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: MAX, PHM, OVD Dated: July 13, 2017 Received: July 14, 2017

Dear Ms. Adams:

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 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.

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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education (DICE) at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevicesforYou/Industry/default.htm. 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 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 Industry and Consumer Education (DICE) at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely,

Mark N. Melkerson -S

Mark N. Melkerson Director Division of Orthopedic Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K172123

### Device Name

NuVasive® Modulus XLIF Interbody System

### Indications for Use (Describe)

The NuVasive Modulus XLIF Interbody System is indicated for intervertebral body fusion of the spine in skeletally mature patients. The System is designed for use with autogenous and/or allogeneic bone graft comprised of cancellous and/or corticocancellous bone graft to facilitate fusion. When used with or without the Modulus XLIF internal fixation, the system is intended for use with supplemental spinal fixation systems cleared by the FDA for use in the thoracolumbar spine. The devices are to be used in patients who have had at least six months of non-operative treatment.

The NuVasive Modulus XLIF Interbody System is intended for use in interbody fusions in the thoracolumbar spine from T1 to T12 and at the thoracolumbar junction (T12-L1), and for use in the lumbar spine from L1 to S1, for the treatment of symptomatic disc degeneration (DDD) or degenerative spondylolisthesis at one or two adjacent levels, including thoracy disc herniation (with myelopathy and/or radiculopathy with or without axial pain). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The NuVasive Modulus XLIF Interbody System can be used as an adjunct to fusion in patients diagnosed with multilevel degenerative scoliosis.

Type of Use (Select one or both, as applicable)

| <div> <span style="font-size: 10px;">☑</span> Prescription Use (Part 21 CFR 801 Subpart D) </div> | <div> <span style="font-size: 10px;">☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) </div> |
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Image /page/3/Picture/0 description: The image shows the logo for Nuvasive. The logo consists of a stylized leaf shape in purple and gray, followed by the company name "NUVASIVE" in gray, sans-serif font. The logo is clean and modern, suggesting a focus on innovation and technology.

# 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.

Cynthia Adams Regulatory Affairs Specialist NuVasive, Incorporated 7475 Lusk Blvd. San Diego, California 92121 Telephone: [phone]

Date Prepared: September 29, 2017

#### Device Name B.

| Trade or Proprietary Name: | NuVasive® Modulus XLIF Interbody System |
|----------------------------|-----------------------------------------|
| Common or Usual Name: | Intervertebral Body Fusion Device |
| Classification Name: | Intervertebral Body Fusion Device |

| Device Class: | Class II |
|-----------------|-------------------|
| Classification: | 21 CFR § 888.3080 |
| Product Code: | MAX, PHM, OVD |

#### C. Predicate Devices

The subject NuVasive Modulus XLIF Interbody System is substantially equivalent to the primary predicate device Modulus XLIF Interbody System cleared in 510(k) K163230. Additional predicates include: CoRoent Thoracolumbar System (K170962), Lumbar Interbody Implants (K161230). CoRoent XL-F System (K140479), and MLX - Medial Lateral Expandable Lumbar Interbody System (K153105). Reference predicate include ALIF Buttress Plate System (K143065).

#### Device Description D.

The subject NuVasive Modulus XLIF Interbody System are interbody implants manufactured from titanium alloy (Ti-6Al-4V ELI) powder conforming to ASTM F3001. The solid and porous structures are simultaneously built using a powder bed fusion method. The hollow core, or graft aperture, allows for packing of graft to aid in the promotion of a solid fusion. Similarly, the macroporous internal lattice structure provides additional space for graft packing. The microporous, textured surface on the superior and inferior ends of the device serves to grip the adjacent vertebrae to resist migration of the device. An optional internal fixation plate with bone screw manufactured from titanium alloy (Ti-6AI-4V ELI) conforming ASTM F136 or ISO 5832-3 and MP35N conforming to ASTM F562 may be affixed to the adjacent vertebral body to provide additional migration resistance and stability. When used with or without the internal fixation plate and bone screw, the device is intended

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to be used with supplemental spinal fixation systems that are cleared by the FDA for use in the thoracolumbar spine.

The implants are available in a variety sizes and lordotic angles to suit the individual pathology and anatomical conditions of the patient. The device is intended to be used with supplemental spinal fixation systems that are cleared by the FDA for use in the lumbar spine.

The purpose of this submission is to provide an optional internal fixation plate with bone screw.

#### Indications for Use E.

The NuVasive Modulus XLIF Interbody System is indicated for intervertebral body fusion of the spine in skeletally mature patients. The System is designed for use with autogenous and/or allogeneic bone graft comprised of cancellous and/or corticocancellous bone graft to facilitate fusion. When used with or without the Modulus XLIF internal fixation, the system is intended for use with supplemental spinal fixation systems cleared by the FDA for use in the thoracolumbar spine. The devices are to be used in patients who have had at least six months of non-operative treatment.

The NuVasive Modulus XLIF Interbody System is intended for use in interbody fusions in the thoracolumbar spine from T1 to T12 and at the thoracolumbar junction (T12-L1), and for use in the lumbar spine from L1 to S1, for the treatment of symptomatic disc degeneration (DDD) or degenerative spondylolisthesis at one or two adjacent levels, including thoracic disc herniation (with myelopathy and/or radiculopathy with or without axial pain). DDD is defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The NuVasive Modulus XLIF Interbody System can be used as an adjunct to fusion in patients diagnosed with multilevel degenerative scoliosis.

#### F. Technological Characteristics

As was established in this submission, the subject NuVasive Modulus XLIF Interbody System is substantially equivalent to other predicate devices cleared by the FDA for commercial distribution in the United States. The subject device was shown to be substantially equivalent and have the same technological characteristics to its predicate devices through comparison in areas including design, intended use, material composition, and function. This device does not contain software or electrical equipment.

#### G. Performance Data

Non-clinical testing and analysis was performed to demonstrate that the subject NuVasive Modulus XLIF Interbody System is substantially equivalent to other predicate devices. In addition to performance testing previously performed on predicate Modulus XLIF Interbody System (K163230), the following testing and analysis were performed to address the addition of the internal fixation:

- Dynamic axial compression testing (per ASTM F2077) ●
- Dynamic torsion testing (per ASTM F2077) ●
- Screw push-out analysis ●

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Image /page/5/Picture/0 description: The image shows the Nuvasive logo. The logo consists of a stylized leaf shape in purple and gray, followed by the word "NUVASIVE" in gray. The leaf shape is on the left side of the logo, and the word "NUVASIVE" is on the right side.

The results demonstrate that the subject NuVasive Modulus XLIF Interbody System meets the same criteria as the predicate devices, and the subject device was therefore found to be substantially equivalent to the predicates. No clinical studies were conducted.

#### Conclusions H.

Based on the indications for use, technological characteristics, and comparison to predicate devices, the subject NuVasive Modulus XLIF Interbody System has been shown to be substantially equivalent to legally marketed predicate devices.