Devices descending from K123352
51 later devices reach S4 Spinal System through their predicates, nearest generation first.
| Generation | Number | Device | Applicant | Decided | Own descendants | Recalls |
|---|---|---|---|---|---|---|
| +1 | K170266 | Palisade™ Pedicular Fixation System | Spineology, Inc. | 2017 | 2 | — |
| +1 | K170255 | Threshold™ V2 Pedicular Fixation System | Spineology, Inc. | 2017 | 1 | — |
| +1 | K170251 | Threshold™ Pedicular Fixation System | Spineology, Inc. | 2017 | 1 | — |
| +1 | K170268 | Fortress™ Pedicular Fixation System | Spineology, Inc. | 2017 | 1 | — |
| +1 | K162134 | ENNOVATE Spinal System | Aesculap Implant Systems, LLC | 2016 | 2 | — |
| +1 | K130291 | S4 Spinal System | Aesculap Implant System, Inc. | 2013 | 44 | — |
| +2 | K243106 | CarboClear® Hybrid Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2024 | 0 | — |
| +2 | K233793 | CarboClear® X Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2024 | 1 | — |
| +2 | K233944 | CarboClear® X Pedicle Screw System; CarboClear® X Navigated Instruments | CarboFix Orthopedics, Ltd. | 2024 | 3 | — |
| +2 | K232341 | CarboClear® Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2023 | 4 | — |
| +2 | K210963 | ENNOVATE Spinal System | Aesculap Implant Systems, LLC | 2021 | 0 | — |
| +2 | K210716 | CarboClear X Pedicle Screw System, CarboClear X Navigated Instruments | CarboFix Orthopedics, Ltd. | 2021 | 8 | — |
| +2 | K203317 | CarboClear X Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2020 | 9 | — |
| +2 | K200519 | CarboClear® II Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2020 | 11 | — |
| +2 | K182377 | CarboClear® Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2018 | 39 | — |
| +2 | K180433 | Ennovate® | Aesculap Implant Systems, LLC | 2018 | 1 | 1 |
| +2 | K172107 | Threshold™ V2 Pedicular Fixation System, Threshold™ Pedicular Fixation System, Fortress™… | Spineology, Inc. | 2017 | 0 | — |
| +2 | K171438 | Palisade™ Pedicular Fixation System | Spineology, Inc. | 2017 | 1 | — |
| +3 | K240846 | CarboClear® Hybrid Pedicle Screw System; CarboClear® Hybrid Navigated Instruments… | CarboFix Orthopedics, Ltd. | 2024 | 2 | — |
| +3 | K233989 | CarboClear® Posterior Cervical Screw System | CarboFix Orthopedics, Ltd. | 2024 | 2 | — |
| +3 | K231280 | CarboClear® X Pedicle Screw System; CarboClear® X Navigated Instruments; CarboClear® X… | CarboFix Orthopedics, Ltd. | 2023 | 4 | — |
| +3 | K200596 | G21 Cement, VADER® Pedicle System | Icotec AG | 2020 | 27 | 1 |
| +3 | K201926 | CarboClear® Pedicle Screw System, CarboClear® II Pedicle Screw System | CarboFix Orthopedics, Ltd. | 2020 | 10 | — |
| +3 | K201251 | CarboClear Navigated Instruments | CarboFix Orthopedics, Ltd. | 2020 | 9 | — |
| +3 | K193423 | VADER®one Pedicle System MIS and LightMore® Pedicle System 6.0 | Icotec AG | 2020 | 6 | 1 |
| +3 | K190526 | High V+ Bone Cement, CarboClear® Fenestrated Pedicle Screws | CarboFix Orthopedics, Ltd. | 2019 | 28 | — |
| +3 | K190545 | VADER® one Pedicle System MIS and LightMore® Pedicle System 6.0 | Icotec AG | 2019 | 29 | 1 |
| +4 | K254045 | CarboClear® Posterior Cervical Screw System; CarboClear® Hybrid Posterior Cervical Screw… | CarboFix Orthopedics, Ltd. | 2026 | 0 | — |
| +4 | K252327 | CMORE® CT System; CMORE® CT System Navigated Instruments | Icotec AG | 2025 | 1 | — |
| +4 | K242900 | VADER® Pedicle System and VADER®one Pedicle System | Icotec AG | 2025 | 0 | — |
| +4 | K242297 | Reform Pedicle Screw System | Precision Spine, Inc. | 2024 | 0 | — |
| +4 | K231809 | Momentum® Posterior Spinal Fixation System with G21 V-STEADY Bone Cement; Momentum® MIS… | Ulrich Medical USA | 2023 | 1 | — |
| +4 | K230774 | PERLA® TL System; TEKTONA® HV US Bone Cement | Spineart | 2023 | 0 | — |
| +4 | K222789 | VADER® Pedicle System, G21 Cement | Icotec AG | 2023 | 5 | 2 |
| +4 | K221926 | Invictus® Bone Cement, Invictus Spinal Fixation System | Alphatec Spine, Inc. | 2022 | 14 | — |
| +5 | K251719 | Momentum® Posterior Spinal Fixation System | Ulrich Medical USA, Inc. | 2025 | 0 | — |
| +5 | K232628 | VADER® Pedicle System | Icotec AG | 2024 | 1 | — |
| +5 | K232044 | Invictus Robotic Navigation Instruments | Alphatec Spine, Inc. | 2023 | 3 | — |
| +5 | K232275 | Invictus® Spinal Fixation System | Alphatec Spine, Inc. | 2023 | 11 | — |
| +5 | K230721 | ATEC Lateral Plate System | Alphatec Spine, Inc. | 2023 | 0 | — |
| +6 | K261284 | Invictus® Small Stature Spinal Fixation System; Invictus® 2.0 Spinal Fixation System | Alphatec Spine, Inc. | 2026 | 0 | — |
| +6 | K253216 | IntraOp Alignment System; CONTOUR3D Bending System | Alphatec Spine, Inc. | 2026 | 0 | — |
| +6 | K253615 | Invictus Bands System | Alphatec Spine, Inc. | 2026 | 0 | — |
| +6 | K252597 | Valence Robotic Navigation System; Valence Robotic Navigation Instruments (For Use with… | Alphatec Spine, Inc. | 2026 | 1 | — |
| +6 | K242364 | IdentiTi™ II Interbody System | Alphatec Spine, Inc. | 2024 | 4 | — |
| +6 | K241519 | Invictus® Small Stature Spinal Fixation System | Alphatec Spine, Inc. | 2024 | 2 | — |
| +6 | K240951 | Invictus Robotic Navigation Instruments | Alphatec Spine | 2024 | 2 | — |
| +7 | K261020 | Symmetrix™ L Spinal System | Medtronic Sofamor Danek USA, Inc. | 2026 | 0 | — |
| +7 | K251575 | IdentiTi™ II ALIF Standalone Interbody System; Transcend™ ALIF Standalone Interbody System | Alphatec Spine | 2025 | 0 | — |
| +7 | K251080 | IdentiTi II Cervical Interbody System | Alphatec Spine, Inc. | 2025 | 0 | — |
| +7 | K251617 | X-PAC® TLIF Expandable Posterior Cage System; X-PAC® LLIF Expandable Lateral Cage System | Expanding Innovations, Inc. | 2025 | 0 | — |