MODIFICATION TO VIPER SPINE SYSTEM

K073562 · Depuy Spine, Inc. · NKB · May 15, 2008 · Orthopedic

Device Facts

• Record ID: K073562
• Device Name: MODIFICATION TO VIPER SPINE SYSTEM
• Applicant: Depuy Spine, Inc.
• Product Code: NKB · Orthopedic
• Decision Date: May 15, 2008
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3070
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The VIPER Spine System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine. The VIPER Spine System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients. When used in a posterior percutaneous approach with MIS instrumentation, the VIPER System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients. With the exception of degenerative disc disease (DDD), the PEEK rods and associated components of the VIPER Spine System may be used for the aforementioned indications in skeletally mature patients. The EXPEDIUM Spine System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine. The EXPEDIUM™ Spine System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudarthrosis; and failed previous fusion in skeletally mature patients. With the exception of degenerative disc disease (DDD), the PEEK rods and associated components of the EXPEDIUM Spine System may be used for the aforementioned indications in skeletally mature patients.

Device Story

VIPER and EXPEDIUM Spine Systems provide spinal stabilization via pedicle and nonpedicle fixation; intended for use in thoracic, lumbar, and sacral spine. Systems utilize rods, setscrews, and associated hardware to immobilize spinal segments as adjunct to fusion. Rods manufactured from PEEK polymer (with/without barium sulfate) and tantalum wire; setscrews from titanium alloy. Used by surgeons in clinical settings for patients with degenerative disc disease, trauma, deformities, or tumors. Device provides mechanical support to facilitate fusion; benefits patient by stabilizing unstable spinal segments. Performance characterized via mechanical bench testing.

Clinical Evidence

Bench testing only. Performance data per ASTM F 1717 and ASTM F 1798 submitted to characterize system components.

Technological Characteristics

Rod components: medical grade PEEK polymer (with/without 6% BaSO4 filler) and ASTM F 560 tantalum wire. Setscrews: ASTM F 136 titanium alloy. Mechanical testing per ASTM F 1717 and ASTM F 1798.

Indications for Use

Indicated for skeletally mature patients requiring spinal immobilization/stabilization as an adjunct to fusion. Treats degenerative disc disease, spondylolisthesis, trauma (fracture/dislocation), spinal stenosis, scoliosis, kyphosis, lordosis, tumor, pseudoarthrosis, and failed previous fusion. Used for noncervical pedicle and nonpedicle fixation. PEEK rods excluded for 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.

Predicate Devices

• CD HORIZON® Legacy Spinal System (K050809, K063670)
• VIPER Spine System (K041801, K071860)
• MOSS Miami Spine System (K011182)
• EXPEDIUM Spine System (K033901, K062174)

Submission Summary (Full Text)

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Traditional 510(k) Submission -- VIPERTM and EXPEDIUM™ PB

### 5. 510(K) SUMMARY

#### 510(k) Summary - VIPERTM Spine System 5.1.

| Submitter: | DePuy Spine, Inc.<br>325 Paramount Drive<br>Raynham, MA 02767 |
|------------|---------------------------------------------------------------|
|------------|---------------------------------------------------------------|

MAY 15 2008

| Contact Person: | Christopher Klaczyk |
|-----------------|----------------------------|
| | Regulatory Project Manager |
| Voice: | [phone] |
| Fax: | [phone] |
| E-Mail: | [e-mail] |

February 21, 2008 Date Prepared:

- Device Class: Class III
Classification Name: Pedicle screw spinal fixation per 21 CFR §888.3070

> Spinal interlaminar fixation orthosis per 21 CFR §888.3050

Spinal intervertebral body fixation orthosis per 21 CFR §888.3060

- Classification Panel: Orthopedics
# FDA Panel Number: 87

| Product Code(s): | NKB, MNI, MNH, KWP, KWQ |
|------------------|-------------------------|
|------------------|-------------------------|

Proprietary Name: VIPERTM Spine System

CD HORIZON® Legacy Spinal System (Medtronic Predicate Devices: Sofamor Danek: K050809, K063670) VIPER Spine System (K041801, K071860) MOSS Miami Spine System (K011182)

Device Description: This submission addresses additional rod components.

The VIPER Spine System is intended to provide Intended Use: immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

ﯿ

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The VIPER Spine System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies): spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

When used in a posterior percutaneous approach with MIS instrumentation, the VIPER System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation): spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

With the exception of degenerative disc disease (DDD), the PEEK rods and associated components of the VIPER Spine System may be used for the aforementioned indications in skeletally mature patients.

- Materials: Rod components are manufactured from medical grade PEEK (polyetheretherketone) polymer both with and without 6% barium sulfate (BaSO4) filler and ASTM F 560 implant grade tantalum wire. Setscrew components are manufactured from ASTM F 136 implant grade titanium allov.
Performance Data: Performance data per ASTM F 1717 and ASTM F 1798 were submitted to characterize the subject spine system components addressed in this notification.

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Traditional 510(k) Submission – VIPER™ and EXPEDIUM™ PEEK Rods

### 5.2. 510(k) Summary - EXPEDIUM™ Spine System

| Submitter: | DePuy Spine, Inc.<br>325 Paramount Drive<br>Raynham, MA 02767 | | |
|-----------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--|
| Contact Person: | Christopher Klaczyk<br>Regulatory Project Manager<br>Voice: [phone]<br>Fax: [phone]<br>E-Mail: [e-mail] | | |
| Date Prepared: | February 21, 2008 | | |
| Device Class: | Class III | | |
| Classification Name: | Pedicle screw spinal fixation per 21 CFR §888.3070<br>Spinal interlaminar fixation orthosis per 21 CFR §888.3050<br>Spinal intervertebral body fixation orthosis per 21 CFR §888.3060 | | |
| Classification Panel: | Orthopedics | | |
| FDA Panel Number: | 87 | | |
| Product Code(s): | NKB, MNI, MNH, KWP, KWQ | | |
| Proprietary Name: | EXPEDIUM™ Spine System | | |
| Predicate Devices: | CD HORIZON® Legacy Spinal System (Medtronic<br>Sofamor Danek; K050809, K063670)<br>EXPEDIUM Spine System (K033901, K062174)<br>MOSS Miami Spine System (K011182) | | |
| Device Description: | This submission addresses additional rod components | | |

The EXPEDIUM Spine System is intended to provide Intended Use: immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

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| | The EXPEDIUM Spine System is intended for noncervical<br>pedicle fixation and nonpedicle fixation for the following<br>indications: degenerative disc disease (defined as back pain<br>of discogenic origin with degeneration of the disc<br>confirmed by history and radiographic studies);<br>spondylolisthesis; trauma (i.e., fracture or dislocation);<br>spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or<br>lordosis); tumor; pseudarthrosis; and failed previous fusion<br>in skeletally mature patients. |
|-------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | With the exception of degenerative disc disease (DDD), the<br>PEEK rods and associated components of the EXPEDIUM<br>Spine System may be used for the aforementioned<br>indications in skeletally mature patients. |
| Materials: | Rod components are manufactured from medical grade<br>PEEK (polyetheretherketone) polymer both with and<br>without 6% barium sulfate (BaSO4) filler and ASTM F 560<br>implant grade tantalum wire. Setscrew components are<br>manufactured from ASTM F 136 implant grade titanium<br>alloy. |
| Performance Data: | Performance data per ASTM F 1717 and ASTM F 1798<br>were submitted to characterize the subject spine system<br>components addressed in this notification. |

.

DePuy Spine, Inc., a Johnson & Johnson Company

:

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Image /page/4/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a stylized eagle or bird-like symbol with three curved lines representing its wings or feathers. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

# MAY 15 2008

DePuy Spine % Mr. Christopher Klaczyk Regulatory Project Manager 325 Paramount Drive Raynham, MA 02767

Re: K073562

> Trade/Device Name: VIPER™ and EXPEDIUM™M Spine Systems Regulation Number: 21 CFR 888.3070 Regulation Name: Pedicle screw spinal system Regulatory Class: III Product Code: NKB, MNI, MNH Dated: May 12, 2008 Received: May 13, 2008

Dear Mr. Klaczyk:

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.

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 – Mr. Christopher Klaczyk

This letter will allow you to begin marketing your device as described in your Section 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), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at [phone]. For questions regarding of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at [phone]. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at toll-free number [phone] or [phone] or the Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Mark M. Millman

Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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### 4. INDICATIONS FOR USE STATEMENT 4.1. INDICATIONS FOR USE STATEMENT - VIPER SPINE SYSTEM

510(k) Number (if known): K073562

Device Name: VIPERTM Spine System

## Indications For Use:

The VIPER Spine System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The VIPER Spine System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

When used in a posterior percutaneous approach with MIS instrumentation, the VIPER System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

With the exception of degenerative disc disease (DDD), the PEEK rods and associated components of the VIPER Spine System may be used for the aforementioned indications in skeletally mature patients.

Prescription Use ﻷ (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 | |
| | Page |
| DePuy Spine, Inc., a Johnson & Johnson Company | |
| 510(k) Number | K073562 |
| | Page 4-1 |

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### INDICATIONS FOR USE STATEMENT - EXPEDIUM SPINE 4.2. SYSTEM

510(k) Number (if known): K073562

Device Name: EXPEDIUM™ Spine System

Indications For Use:

The EXPEDIUM Spine System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The EXPEDIUM™ Spine System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudarthrosis; and failed previous fusion in skeletally mature patients.

With the exception of degenerative disc disease (DDD), the PEEK rods and associated components of the EXPEDIUM Spine System may be used for the aforementioned indications in skeletally mature patients.

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)

NihleO, for mxn

Division of General, Restorative. and Neurological Devices

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ohnson & Johnson Company

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