INDICATIONS, SAFETY, AND WARNINGS Anatomic PEEK™ PTC Cervical Fusion System

IMPORTANT INFORMATION ON THE ANATOMIC PEEK™ PTC CERVICAL FUSION SYSTEM PURPOSE

PURPOSE

This device is a fusion device intended for stabilization use and to promote bone fusion during the normal healing process following surgical correction of disorders of the spine. The product should be implanted only by a physician who is thoroughly knowledgeable in the implant’s material and surgical aspects and who has been instructed as to its mechanical and material applications and limitations. This device is manufactured from medical grade polyetheretherketone (PEEK), tantalum markers, a commercially pure titanium (CP Ti) coating, and is provided sterile.

DESCRIPTION

The ANATOMIC PEEK™ PTC Cervical Fusion System consists of cages of various widths and heights which can be inserted between two cervical vertebral bodies to give support and correction during cervical interbody fusion surgeries. The hollow geometry of the implants allows them to be packed with autogenous bone graft and/or allogenic bone graft comprised of cancellous and/or corticocancellous bone graft. The ANATOMIC PEEK PTC devices must be used with supplemental fixation. No warranties, express or implied, are made. Implied warranties of merchantability and fitness for a particular purpose or useare specifically excluded. Medical grade tantalum, medical grade CP Ti, and medical grade PEEK may be used together. Never use titanium or titanium alloy implants with stainless steel in the same construct.

INDICATIONS

The ANATOMIC PEEK PTC Cervical Fusion System is indicated for use in skeletally mature patients with degenerative disc disease (DDD) of the cervical spine with accompanying radicular symptoms at one disc level or two contiguous levels. DDD isdefined as discogenic pain with degeneration of the disc confirmed by patient history and radiographic studies.

The ANATOMICPEEK PTC Cervical Fusion System is used to facilitate intervertebral body fusion in the cervical spine and is placed via ananterior approach from the C2-C3 disc space to the C7-T1 disc space using autogenous bone and/or allograft bone graft comprised of cancellous and/or corticocancellous bone graft, and/or demineralized allograft bone with bone marrow aspirate.

The ANATOMIC PEE PTC Cervical Fusion System is to be used with supplemental fixation. Patients should have at least six weeks of non-operative treatment prior to treatment with an intervertebral cage.

CONTRAINDICATIONS

The ANATOMIC PEEK PTC device is not intended for posterior surgical implantation. Contraindications also include, but are not limited to:

  • Any medical or surgical condition which would preclude the potential benefit of spinal implant surgery such as the presence of tumors or congenital abnormalities, elevation of sedimentation rate unexplained by other diseases, elevation of white blood count (WBC), or a marked left shift in theWBC differential count.
  • Any patient having inadequate tissue coverage over the operative site or where there is inadequate bone stock, bone quality, or anatomical definition.
  • Any patient unwilling to cooperate with postoperative instructions.
  • Fever or leukocytosis.
  • Infection local to the operative site and/or signs of local inflammation.
  • Mental illness.
  • Morbid obesity.
  • Pregnancy.
  • Any case not requiring fusion.
  • Suspected or documented allergy or intolerance to the component materials.
  • This device must not be used for pediatric cases.
  • Patients with a known hereditary or required bone friability or calcification problem should not be considered for this type of surgery.
  • Prior fusion at the level to be treated.
  • Any patient in which implant utilization would interfere with anatomical structures or expected physiological performance.
  • Any case that requires the mixing of metals from two different components or systems.

Nota bene: Although not absolute contraindications, conditions to be considered as potential factors for not using this device include:

  • Severe bone resorption.
  • Osteomalacia.
  • Severe osteoporosis.

POTENTIAL ADVERSE EVENTS

All of the possible adverse events or complications associated with spinal fusion surgery without instrumentation are possible. With instrumentation, a listing of possible adverse events or complications includes, but is not limited to:

  • Bone loss or decrease in bone density possibly caused by stress shielding.
  • Cauda equina syndrome, neuropathy, neurological deficits (transient or permanent), paraplegia, paraparesis, reflex deficits, arachnoiditis, and/or muscle loss.
  • Loss of spinal mobility or function.
  • Inability to perform the activities of daily living.
  • Change in mental status.
  • Death.
  • Development of respiratory problems (e.g. pulmonary embolism, atelectasis, bronchitis, pneumonia, etc.).
  • Disassembly, bending, and/or breakage of any or all of the components.
  • Dural tears, pseudomeningocele, fistula, persistent CSF leakage, and/or meningitis.
  • Early or late loosening of the components.
  • Implant migration.
  • Foreign body (allergic) reaction to the implants, debris, corrosion products, including metallosis, staining, tumor formation, and/or autoimmune disease.
  • Fracture, microfracture, resorption, damage, penetration, and/or retropulsion of any spinal bone, of the autograft, or at the bone graft harvest site at, above, and/or below the level of surgery.
  • Ileus, gastritis, bowel obstruction or other types of gastrointestinal complications.
  • Graft donor site complications including pain, fracture, infection, or wound healing problems.
  • Hemorrhage, hematoma, occlusion, seroma, edema, embolism, stroke, excessive bleeding, phlebitis, damage to blood vessels, or cardiovascular system compromise.
  • Wound necrosis or wound dehiscence.
  • Herniated nucleus pulposus, disc disruption, or degeneration at, above, or below the level of surgery.
  • Infection.
  • Loss of neurologial function, including paralysis (complete or incomplete), dysesthesia, hyperesthesia, anesthesia, paraesthesia, appearance or radiculopathy, and/or the development or continuation of pain, numbness, neuroma, tingling sensation, sensory loss, and/or spasms.
  • Non-union (or pseudarthrosis), delayed union, and/or mal-union.
  • Postoperative change in spinal curvature, loss of correction, height, and/or reduction.
  • Scar formation possibly causing neurological compromise around nerves and/or pain.
  • Subsidence of the device into vertebral body(ies).
  • Tissue or nerve damage, irritation, and/or pain caused by improper positioning and placement of implants or instruments.

Note: additional surgery may be necessary to correct some of these anticipated adverse events.

WARNINGS

This system was designed for single patient use only. Do not reuse, reprocess, or resterilize this product. Reuse, reprocessing, or resterilization may compromise the structural integrity of the device and/or create a risk of contamination of the device, which could result in patient injury, illness, or death.

A successful result is not always achieved in every surgical case. This fact is especially true in spinal surgery where other patient conditions may compromise the results. Use of this product in cervical interbody fusion procedures without autograft and/or allogenic bone graft comprised of cancellous and/or corticocancellous bone graft may not be successful. No spinal implant can withstand body loads without the support of bone. In this event, bending, loosening, disassembly, and/or breakage of the device(s) will eventually occur.

Preoperative and operating procedures including knowledge of surgical techniques, proper selection and place-ment of the implant, and good reduction are important considerations in the success of surgery.

Patients with previous spinal surgery at the levels to be treated may have different clinical outcomes compared to those without a previous surgery This system should not be used in any case not described in the indications.

Further, the proper selection and compliance of the patient will greatly affect the results. Patients who smoke have been shown to have an increased incidence of non-unions. These patients should be advised of this fact and warned of this consequence. Obese, malnourished, and/or alcohol abuse patients are also poor candidates for spine fusion.

PRECAUTIONS

Physician note: Although the physician is the learned intermediary between the company and the patient, the important medical information given in this document should be conveyed to the patient. Based on fatigue testing results, when using the ANATOMIC PEEK™ PTC Cervical Fusion System, the physician/ surgeon should consider the levels of implantation, patient weight, patient activity level, other patient conditions, etc. which may impact the performance of this system.

For US audiences only

Caution: federal law (USA) restricts these devices to sale by or on the order of a physician.