MODIFICATION TO ALTIUS OCT SYSTEM

K043229 · Interpore Cross Intl. · KWP · Dec 21, 2004 · Orthopedic

Device Facts

• Record ID: K043229
• Device Name: MODIFICATION TO ALTIUS OCT SYSTEM
• Applicant: Interpore Cross Intl.
• Product Code: KWP · Orthopedic
• Decision Date: Dec 21, 2004
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3050
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (occiput-T3), the Altius OCT System is indicated for: . DDD (neck pain of discogenic origin with degeneration of the disc as confirmed by patient history and radiographic studies) . Spondylolisthesis . Spinal stenosis t . Fracture/dislocation . Atlantoaxial fracture with instability . Occipitocervical dislocation . Revision of previous cervical spine surgery . Tumors The occipital bone screws are limited to occipital fixation only. The Altius OCT System can be linked to the Synergy Spinal System using the Transitional Rods and Rod Connectors from the Altius OCT System.

Device Story

Altius OCT System is a spinal fixation orthosis; composed of titanium rods, bone screws, hooks, set screws, nuts, cross connectors, and plates. Used by surgeons in clinical settings to promote fusion of cervical spine and occipito-cervico-thoracic junction (occiput-T3). Surgeon fixes occipital plate to occiput with bone screws; places bone screws in thoracic spine (T1-T3) and hooks in cervical spine; inserts and locks pre-bent rods with screws and nuts. System provides mechanical stabilization to facilitate bone fusion; can be linked to Synergy Spinal System via transitional rods and connectors. Benefits patient by stabilizing unstable spinal segments.

Clinical Evidence

No clinical data provided; substantial equivalence based on biomechanical performance and design similarity.

Technological Characteristics

Titanium spinal fixation system; components include rods, bone screws, hooks, set screws, nuts, cross connectors, and plates. Mechanical stabilization via rigid construct. No software or electronic components.

Indications for Use

Indicated for patients requiring cervical spine and occipito-cervico-thoracic (occiput-T3) fusion due to DDD, spondylolisthesis, spinal stenosis, fracture/dislocation, atlantoaxial fracture with instability, occipitocervical dislocation, tumor, or revision of previous cervical surgery. Occipital bone screws limited to occipital fixation.

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.

Reference Devices

• Synergy Spinal System

Submission Summary (Full Text)

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### 510(k) SUMMARY

### SUBMITTED BY

Wendy Spielberger, RAC Lead Regulatory and Clinical Affairs Staff Interpore Cross International 181 Technology Drive Irvine, California 92618 [phone]

This summary of 510(k) substantial equivalence information is being submitted in accordance with the requirements of 21 CFR §807.92.

#### CLASSIFICATION, COMMON OR USUAL NAME, DEVICE NAME

| Classification Name: | Appliance, Fixation, Spinal Interlaminal Orthosis |
|-------------------------|---------------------------------------------------|
| Common/Usual Name: | Spinal Interlaminal Orthosis Fixation |
| Product Classification: | 21 CFR §888.3050, Class II |
| Product Code: | KWP |
| Proprietary Name: | Altius OCT System |

#### PREDICATE DEVICE

Predicate device information is included in this premarket notification.

#### INDICATIONS-FOR-USE

When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (occiput-T3), the Altius OCT System is indicated for:

- . DDD (neck pain of discogenic origin with degeneration of the disc as confirmed by patient history and radiographic studies)
- Spondylolisthesis .
- Spinal stenosis t
- . Fracture/dislocation
- . Atlantoaxial fracture with instability
- Occipitocervical dislocation .
- Revision of previous cervical spine surgery �
- . Tumors

The occipital bone screws are limited to occipital fixation only.

The Altius OCT System can be linked to the Synergy Spinal System using the Transitional Rods and Rod Connectors from the Altius OCT System.

#### DEVICE DESCRIPTION

The Altius OCT System is a titanium system composed of rods, bone screws, hooks, set screws, nuts, cross connectors, plates. For occipito-cervico-thoracic fusion, the occipital plate is fixed to the occiput with bone screws. The pre-bent rod is cut to the appropriate length. Bone screws are placed in the thoracic spine (T1-T3) and hooks are placed in the cervical spine. The rod is inserted and the construct is locked with screws and nuts. Cross connectors can be added to the construct.

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# COMPARISON TO THE PREDICATE DEVICE

Based on the same indications for use, intended use, similarity in materials of construction and equivalent biomechanical performance, the Altius OCT System is considered substantially equivalent to the legally marketed predicate device.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 21 2004

Ms. Wendy Spielberger, RAC Lead Regulatory and Clinical Affairs Staff INTERPORE CROSS International 181 Technology Drive Irvine. CA 92618-2402

Re: K043229

Trade/Device Name: Altius OCT System Regulation Number: 21 CFR 888.3050 Regulation Name: Spinal interlaminal fixation orthosis Regulatory Class: Class II Product Code: KWP Dated: November 19, 2004 Received: November 22, 2004

Dear Ms. Spielberger:

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 for abovenoveior 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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 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); 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.

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Page 2 - Ms. Wendy Spielberger

This letter will allow you to begin marketing your device as described in your Section 510(k) This letter will anow you to organ market of substantial equivalence of your device to a legally premarket notification: "The PPF Intelligestion 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), please If you desire specific davice 101 Jour 2019 276-0120. Also, please note the regulation entitled, contact the Office of Comptimation" (21 CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small other general informational and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Clawill

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications for Use

## 510(k) Number (if known): KO4 3229

Device Name: Altius OCT System

Indications-For-Use:

When intended to promote fusion of the cervical spine and occipito-cervico-thoracic junction (occiput-T3), the Interpore Cross International Altius OCT System is indicated for:

- DDD (neck pain of discogenic origin with degeneration of the disc as . confirmed by patient history and radiographic studies)
- Spondyloslisthesis .
- Spinal stenosis
- . Fracture/dislocation
- . Atlantoaxial fracture with instability
- . Occipitocervical dislocation
- Revision of previous cervical spine surgery .
- ◆ Tumors

The occipital bone screws are limited to occipital fixation only.

The Altius OCT System can be linked to the Synergy Spinal System using the Transitional Rods and Rod Connectors from the Altius OCT System.

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)

**(Division Sign-Off)**

Division of General, Restorative, and Neurological Devices

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510(k) Number K043225