Mobi-C CERVICAL DISC TWO-LEVEL APPLICATIONS

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Mobi-C CERVICAL DISC Product Brochure Features TWO-LEVEL APPLICATIONS INDICATIONS

mobi-c Cervical disc bone sparing two-level indications Ease of insertion mobile bearing Over 17,000 Mobi-C discs have been implanted in 25 countries since 2004.

mobi-c is the first and only Approved EXECUTIVE two-level SUMMARY disc 1 mobi-c is superior to acdf at two levels 2 Mobi-C demonstrated superiority in overall trial success compared to ACDF at 24 months. mobi-c had lower rates of adjacent level degeneration The deterioration of adjacent segments at 24 months compared to baseline was: 2.9% for Mobi-C compared to 18.1% for ACDF at the inferior level. 13.1% for Mobi-C compared to 33.3% for ACDF at the superior level. In the FDA prospective, randomized, controlled trial, 330 patients were studied at 24 centers. * Fisher Exact test used to compare treatments to establish superiority. mobi-c had fewer secondary surgeries Only 3.1% of Mobi-C patients compared to 11.4% of ACDF patients reported secondary surgeries at the index levels through 24 months. Note: Success criteria for these Mobi-C Independent Device Exemption (IDE) trial results can be found on page 7. 2-3

mobi-c: EXECUTIVE mobile SUMMARY bearing controlled mobility Lateral Translation ± 10 Lateral Bend Rotation Self-adjusting A/P Translation ± 10 Flexion/Extension Patented, mobile bearing core Flat bottom designed to translate up to 1mm and rotate on the inferior endplate Domed surface designed to articulate angularly with the superior endplate Tabs provide a safety stop designed to control mobility and to resist expulsion The center of rotation at each level of the cervical spine is variable and constantly changing 3. Mobi-C was designed to adapt to the Instantaneous Axis of Rotation through its self-adjusting mobile core. The Mobi-C mobile core: Is designed to facilitate independent and coupled motion similar to natural cervical spine motion. Moves with the spine and does not dictate a predetermined, fixed axis of rotation. Flexion/Extension with A/P translation Lateral Bending with lateral translation

Mobi-c: bone sparing no bone chiseling Mobi-C s mobile core is designed to create low stress at the implant to bone interface. The Mobi-C requires: No invasive keels or screws. No bone removal for keel preparation. No additional operative steps for keel cutting. Intact endplates, compared to endplates prepared for keels, provide: A preserved surface for the implant, ideal for two-level implantation. Intraoperative flexibility to optimize implant positioning. short and long term stability Lateral, inclined teeth: Purchase in the apophyseal ring to provide initial stability Designed to resist migration Superior dome: Designed to match the natural, bony anatomy enabling short and long term stability Plasma sprayed titanium and hydroxyapatite coated endplates: Encourage bony ongrowth for long term stability 4-5

mobi-c: ease of insertion one-step insertion No drilling or chiseling required No additional exposure or operative steps required for screw or keel placement PRE-Assembled implants The Mobi-C is delivered pre-assembled on a disposable PEEK cartridge. PEEK cartridge assembles easily to the implant inserter saving operative steps Mobi-C Cervical Disc PEEK Cartridge PEEK cartridge allows a radiolucent view of the implant for optimal positioning

mobi-c: product details indications The Mobi-C Cervical Disc Prosthesis is indicated in skeletally mature patients for reconstruction of the disc from C3-C7 following discectomy at two contiguous levels for intractable radiculopathy (arm pain and/or a neurological deficit with or without neck pain) or myelopathy due to abnormality localized to the level of the disc space and at least one of the following conditions confirmed by radiographic imaging (CT, MRI, X-rays): herniated nucleus pulposus, spondylosis (defined by the presence of osteophytes), and/or visible loss of disc height compared to adjacent levels. The Mobi-C Cervical Disc Prosthesis is implanted using an anterior approach. Patients should have failed at least 6 weeks of conservative treatment or demonstrated progressive signs or symptoms despite nonoperative treatment prior to implantation of the Mobi-C Cervical Disc Prosthesis. sizing options Depth x Width (mm) 13x15 13X17 15X15 15X17 15X19 Height (mm) 5, 6, and 7 IDE Success Criteria Overall Trial Success Trial success was based on a composite endpoint. A patient was considered a success at 24 months if all of the following criteria were met: Sufficient NDI improvement No secondary surgery at the treated level No radiographic failure No neurologic deterioration No adverse event determined to be a major complication References Adjacent Segment Degeneration Adjacent segment degeneration was assessed at the spinal segment immediately above and below the treated levels. An independent core lab assessed degeneration using the Kellgren-Lawrence five point grading scale. An adjacent segment was counted as having degenerated if the segment worsened by 1 grade or more. 1 As of 7/30/13 in the USA 2 The control group in the Mobi-C IDE clinical trial was ACDF using allograft bone and an anterior cervical plate. 3 Amevo et al 1991 Secondary Surgeries At the Treated Levels The patient was considered a success in terms of secondary surgery if none of the following were necessary at either of the treated levels: removal, revision, reoperation, or supplemental fixation. 6-7

Indications for Use: The Mobi-C Cervical Disc Prosthesis is indicated in skeletally mature patients for reconstruction of the disc from C3-C7 following discectomy at two contiguous levels for intractable radiculopathy (arm pain and/or a neurological deficit) with or without neck pain, or myelopathy due to abnormality localized to the level of the disc space and at least one of the following conditions confirmed by radiographic imaging (CT, MRI, X-rays): herniated nucleus pulposus, spondylosis (defined by the presence of osteophytes), and/or visible loss of disc height compared to adjacent levels. The Mobi-C Cervical Disc Prosthesis is implanted using an anterior approach. Patients should have failed at least 6 weeks of conservative treatment or demonstrated progressive signs or symptoms despite nonoperative treatment prior to implantation of the Mobi-C Cervical Disc Prosthesis. Note: Please refer to the Mobi-C Summary of Safety and Effectiveness Data (PMA P110009) at www.fda.gov for complete study results. www.ldrmedical.com www.cervicaldisc.com United States 13785 Research Boulevard Suite 200 Austin, Texas 78750 512.344.3333 France Hôtel de bureau 1 4, rue Gustave Eiffel 10 430 Rosières Près Troyes, FRANCE +33 (0)3 25 82 32 63 China Unit 06, Level 16, Building A, Beijing Global Trade Center #36 North Third Ring Road East, Dongcheng District, Beijing, China, 100013 +86 10 58256655 Brazil Av. Pereira Barreto, 1395-19º Floor Room 192 to 196 Torre Sul-Bairro Paraíso Santo André / São Paulo-Brazil CEP 09190-610 +55 11 4332 7755 REF: MB B 2 REV A 07.2013 LDR, LDR Spine, LDR Médical, Avenue, BF+, BF+(Ph), Bi-Pack, C-Plate, Easyspine, Laminotome, L90, MC+, Mobi, Mobi-C, Mobi-L, Mobidisc, ROI, ROI-A, ROI-C, ROI-MC+, ROI-T, SpineTune and VerteBRIDGE are trademarks or registered trademarks of LDR Holding Corporation or its affiliates in France, the United States, and other countries.