Spinal Orthopaedics: A bright future for new technologies?

Publication Date	September 2008
Publisher	Espicom
Product Type	Report
Pages	242
ISBN Number	978-1-85822-329-2
Product Code	ESP00565

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Summary

"By 2012, the global spinal market will achieve revenues of US$10.2 billion and a CAGR of 12% - with faster growth in the future expected"

Although motion preservation devices are expected to take some share from fusion products, this will be offset in the near-term by the rising number of people with spine-related disorders for whom fusion remains the most viable treatment and the increasing adoption of MIS-friendly fusion techniques.

Total Disc Replacemen

The use of current lumbar TDRs is not expected to have a significant impact on the fusion market until products that use the posterior approach are developed, although clinical evidence that promotes current products may lead to a slight improvement in this market. Espicom believes cervical TDRs represent a significant market opportunity and should experience strong growth once they receive reimbursement approval in the US, which is not expected to occur until 2009 at the earliest.

Nucleus Replacement & Dynamic Stabilisation

The potential for nucleus replacement products is currently questionable and Espicom does not believe these products will have a major impact on the market in the near to mid-term. However, dynamic stabilisation products have already proved their worth in Europe and are expected to drive growth in the spinal surgery market in coming years, with an acceleration expected from 2012 as more of these products become available in the US and Japan.

This report provides real insights

For executives working in industry and commerce, the need to understand the issues, players and products in this sector of high-growth potential is essential. That is why Espicom, for 27 years a leading publisher of strategic business information for the medical device community, has published this extensive new report.

In over 240-pages, the report examines the background to market, provides key figures and estimates for market growth and examines in-depth the companies and innovative products that are driving change.

This report answers key business questions

What factors will drive the nucleus replacement market to revenues of $450 million in 2012?
What impact will the increasing use of minimally- invasive surgical techniques have on the disc fusion sector?
What % of the global market will dynamic stabilisation systems command in 2012?
What is the potential for minimally-invasive spinal technology?
How might Synthes and DePuy challenge Medtronic's domination of the spinal sector?
Which emerging US company successfully launched a lumbar TDR product in Europe in May 2008?
Why is industry interest in vertebral compression fractures increasing?

Providing

Comprehensive market forecasts of key technology sectors to 2012

A thorough review of the spinal orthopaedic market worldwide

An examination of key products:

Fusion
Biologic Products
Dynamic Stabilisation
Total/Partial Disc Replacement
Annular Repair
Facet Replacement
Fracture Treatment

A competitive review and market share estimates for the 12 leading companies

A review of 71 companies developing novel spinal treatments and technologies

Spinal motion preservation is just one of the hot topics to capture the industry's attention - but what are the relative strengths and weaknesses of the new approaches and to what degree will they impact fusion as the preferred treatment of choice in the future?

The array of non-fusion technologies being introduced to the market offers a great deal of promise for spinal surgery patients.

However, despite the fact that some of these technologies have been in use in Europe and other international markets for many years, the clinical outcomes data available are extremely limited in proportion to the tens of thousands of fusion procedures performed.

In addition, as regulatory clearance criteria in the US and Japan are by far the most rigorous in the world, the paucity of well-designed studies to prove the safety and effectiveness of artificial discs has hindered the launch of motion preservation products, and therefore growth, in these markets.

Competing technologies are changing the treatment landscape

Although there has been much focus in recent years on the potential of total or partial spinal disc replacement technologies, these devices have so far failed to live up to expectations. There clearly is a need for a viable alternative to fusion and a more promising motion preservation option, dynamic stabilisation, may provide a solution for some patients. Dynamic stabilisation preserves the intervertebral disc and vertebral structure, while also enabling a minimally-invasive posterior approach.

In addition to treatments for degenerative disc disease and deformity, the treatment of vertebral compression fractures is becoming increasingly important. Fractures are often caused by osteoporosis or cancer and their number is therefore increasing with the ageing of the population. Minimally-invasive treatments, such as vertebroplasty and kyphoplasty, that work quickly to stabilise fractures and relieve pain are being rapidly adopted and this segment of the spinal market, termed the ageing spine category, is becoming a major focus for spinal manufacturers.

Content

Executive Summary
Overview
The Spinal Surgery Market
- Global Spinal Market by Procedure, 2006-2007 (US$ Million)
- Fig 1: Global Spinal Market by Procedure, 2007
- Global Spinal Market by Region, 2006-2007 (US$ Million)
- Fig 2: Global Spinal Market by Region, 2007
- United States
- US Clinical Procedures by Ccs Code 158 (Spinal Fusion), 1996-2006
- Europe
- Asia-Pacific Region
Market Players
- Fig 3: Global Spinal Market Shares, 2007*
- Fig 4: Global Spinal Market Shares, 2006*
- Manufacturers Spinal Sales, 2003-2008 (US$ Million)*
- Companies Ranked by Spinal Sales Growth, 2006-2007 (US$ Million)
Market Dynamics
- Gaining Clinical Evidence
- Sport Study
- Intervertebral Disc Herniation
- Degenerative Spondylolisthesis
- Spinal Stenosis
- Increasing Competition
- The Role of Private Equity
- Major Private Equity Companies Spinal Portfolios
- Industry Consolidation
- Major Spinal Acquisitions, 2006-2008
Future Trends and Forecasts
- Fig 5: Global Spinal Market, 2006-2015 (US$ Million)
- Global Spinal Market by Procedure Type, 2007-2013 (US$ Million)
- Fig 6: Global Spinal Market, 2006-2015 (US$ Million)
- Fig 7: Global Spinal Market by Procedure, 2013
Spinal Products and Technologies
Spinal Fusion
- The Fusion Market
- Fig 8: Global Spinal Fusion Market, 2006-2013 (US$ Million)
- Fusion: Market Drivers, Restraints & Future Opportunities
- Thoracolumbar Products
- Product Highlights
- Abbotts Universal Clamp
- Alphatecs Zodiac Line
- Amedicas Valeo Pedicle Screw System
- Custom Spines Issys Products
- Depuys Expedium Products
- Globus Medicals Reverse and Gateway Systems
- Life Spines Lynx Cross Connector System
- Medicreas Pass Products
- Medtronic Products
- Pioneer Surgical Technologys Lowtop Pedicle Screw System
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Signus Medizintechniks Tpn
- Strykers Xia Spinal System
- Surgicrafts Products
- Synthes Pangea Degenerative Spine System
- US Spines Facet Fixation System
- X-Spine Systems Capless Pedicle Screw Systems
- New Anterior Lumbar Plates
- Interbody Devices
- Product Highlights
- Alphatecs Novel Spinal Spacer Systems
- Amedicas Valeo and Arx System
- Globus Medicals Niko Corpectomy Spacer System
- K2ms Aleutian Systems
- Ldr Holdings Roi Partial Vbrs
- Medtronics Capstone
- Rsb Spines Interplate Vbrs
- Spinal Elements Vbrs
- Strykers Avs Pl Peek Spacers
- Synthes Products
- Vertebrations Xycor Spinal Implant
- Cervical Products
- New Anterior Cervical Plate Systems
- Spinal Elements Mosaic Spinal Implant System
- Medicreas C-Jaws
- Minimally-Invasive Spinal Fusion
- Mis Fusion: Market Drivers, Restraints & Future Opportunities
- Leading Products and New Innovations
- Abbotts Minimally-Invasive Systems
- Alphatecs Illico Minimally Invasive System
- Biomets Vuepass Portal Access Surgical System
- Colignes Erriva Elif
- Depuys Mis Products
- Globus Medicals Mars Minimal Access Retractor System
- Innovative Spinal Technologies Paramount Systems
- Interventional Spines Mis Products
- K2ms Serengeti Minimally Invasive Retractor System
- Medtronic Minimal Access Spinal Technologies
- Nuvasive Maximum Access Surgery
- Pioneer Surgical Technologys Quantum Mis Rodding System
- Spinal Elements Mercury Spinal System
- Strykers Mantis
- Trans1s Mis Approach
- Vertiflex Silverbolt Mis Systems
- Zimmers Endius Products
Biologic Products
- Orthobiologics Market by Product, 2007-2012 (US$ Million)
- Orthobiologics Market by Region 2007-2012
- Fig 9: Global Orthobiologics Market Shares, 2007
- Bone Graft Substitutes
- Spinal Biologics: Market Drivers, Restraints & Future Opportunities
- Allograft
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Bone Morphogenetic Proteins
- Medtronics Infuse Bone Graft
- Medtronics Inductos
- Strykers Op-1
- Synthetic Bone Grafts
- New Synthetic Bone Grafts
- Cell-Based Products
- Nuvasives Osteocel
- Spinesmiths Fusionary
- Technologies in Development
- Orthovitas Cortoss Bone Augmentation Material
- Other Biologic Spinal Products
- Co Dons Chondrotransplant Disc
- Isto Technologies Nuqu Injectable Cell-Based Therapy
- Spinal Restorations Biostat Disc Augmentation System
- Spineovations Discseal
Dynamic Stabilisation
- Fig 10: Dynamic Stabilisation Market, 2006-2013 (US$ Million)
- Dynamic Stabilisation: Market Drivers, Restraints & Future Opportunities
- Pedicle Screw-Based Systems
- Pedicle Screw-Based Systems - Competitive Landscape
- Zimmers Dynesys Dynamic Stabilization System
- Zimmer Dto Implant
- Scientx Isobar Products
- Paradigm Spines Coflex Devices
- Paradigm Spines Dss System
- Spinevisions Flexplus
- Disc Motion Technologies True Tsms
- Interventional Spines Percudyn
- Applied Spine Technologies Stabilimax Nz
- Vertiflex Dynabolt Dynamic Stabilization System
- Eden Spines Fx-1 System
- Ulrich Medicals Cosmic Products
- Products in Development
- Depuys Expendium Dynamic Rod System
- Globus Medicals Transition Posterior Dynamic Stabilization System
- Innovative Spinal Technologies Axient Total Dynamic Fixation
- Interspinous Spacer Systems
- Interspinous Spacers - Competitive Landscape
- Medtronic/Kyphons X-Stop Interspinous Process Decompression System
- Abbotts Wallis System
- Medtronics Diam Spinal Stabilization System
- Medtronic/Kyphons Aperius Perclid
- Vertiflex Superion
- Synthes in-Space
- Orthofix Inswing
- Globus Medicals Flexus Interspinous Spacer
- Pioneer Surgical Technologys Bacjac
- Eden Spines Wellex Interspinous Technology
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Gmreis Dynafix Interspinous Dynamic Fixation System
Total Disc Replacement
- Fig 11: Global Tdr Market, 2006-2013 (US$ Million)
- Lumbar Discs
- Market Potential and Future Opportunities
- Fig 12: Lumbar Tdr Market, 2006-2013 (US$ Million)
- Lumbar Tdr: Market Drivers, Restraints & Future Opportunities
- Lumbar Tdr Products and Technologies
- Lumbar Tdr: Competitive Landscape
- Depuys Charit Artificial Disc
- Synthes Prodisc-L
- Medtronics Maverick Artificial Lumbar Disc
- Nexgen Spines Physio-L
- Strykers Flexicore Artificial Lumbar Disc
- Aesculaps Activ-L Artificial Lumbar Disc
- Disc Motion Technologies Truedisc Posterior Artificial Disc
- Ldr Holdings Mobidisc
- Zimmers Dynardi Artificial Lumbar Disc
- Products in Development
- Cervical Discs
- Fig 13: Cervical Tdr Market, 2006-2013 (US$ Million)
- Cervical Tdr: Market Drivers, Restraints & Future Opportunities
- Cervical Tdr Products and Technologies
- Cervical Tdrs - Competitive Landscape
- Synthes Prodisc-C
- Medtronics Prestige Cervical Disc
- Medtronics Prestige Lp Cervical Disc
- Medtronics Bryan Cervical Disc System
- Cervitechs Pcm Artificial Cervical Disc
- Ldrs Mobi-C
- Globus Medicals Secure-C
- Spinalmotions Kineflex|C
- Depuys Discover Cervical Disc
- Spinal Kinetics M6-C
- Vertebrons Cmp
- Osteons Mcd Mobile Cervical Disc
- Aesculaps Activ-C
- Products in Development
Partial Disc Replacement
- Nucleus Replacement
- Fig 14: Nucleus Replacement Market, 2006-2013 (US$ Million)
- Nucleus Replacement: Market Drivers, Restraints and Future Opportunities
- Nucleus Replacement Products and Technologies
- Nucleus Replacement - Competitive Landscape
- Raymedicas Products
- Disc Dynamics Dascor Disc Arthroplasty System
- Pioneer Surgical Technologys Nubac Intradiscal Arthroplasty System
- Sinitecs Sinux Anr
- Products in Development
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Nuvasives Neodisc Cervical Partial Disc Replacement
- Trans1s Pdr Lumbar Partial Disc Replacement
Nucleus Removal
Facet Replacement
- Archus Orthopedics Total Facet Arthroplasty Systems
- Facet Solutions Anatomic Facet Replacement System
- Spinal Elements Zyre Facet Arthroplasty System
- Gerraspines Fenix Facet Implant
Total Posterior Arthroplasty
- Tops-on-Fusion System
Annular Repair
- Anulex Technologies Inclose and Xclose Systems
- Intrinsic Therapeutics Barricaid
- Arthro Kinetics Anres
Fracture Treatment
- Current Options
- Vcf Treatment Options: Vertebroplasty vs Kyphoplasty
- Market Players
- Fig 15: Vcf Treatment Market, 2006-2013 (US$ Million)
- Vertebroplasty
- Arthrocare - Parallax Medical and Cavity Spinewand
- Kyphoplasty and Kyphon
- Fig 16: Kyphon: Kyphoplasty Procedure Growth, 2000-2006
- Fig 17: Kyphons Revenue, Y/E
- Kyphons Sky Bone Expander System
- Spine Waves Staxx Fx Structural Kyphoplasty System
- Cement & Cement Delivery Systems
- Depuys Confidence Spinal Cement System
- Biomets Vcf Products
- Orthovitas Cortoss Bone Augmentation Material
- Spineologys Optimesh
- Products in Development
- Alphatecs Osseofix Spinal Fracture Reduction System
- Aoi Medicals Ascendx Vcf Reduction System
Spinal Implant Manufacturers
The Market Leaders
- Abbott
- Abbott: Recent Spinal Product Approvals
- Alliances
- Replication Medical
- Allosource
- Invibio
- Financial Performance
- Abbott Revenue, 2004-2007 (US$ Million)
- Fig 18: Abbott Spine Sales, 2004-2007 (US$ Million)*
- Alphatec Holdings
- Alphatec: Recent Product Approvals
- R&d Projects
- Alliances
- Depuy
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Stout Medical Group
- Progressive Spinal Technologies
- Jgmg Bengochea
- Roger P Jackson, Md
- Biomet
- Hansen A Yuan
- Invibio
- Financial Performance
- Alphatec Revenue, 2004-2007 (US$ Million)
- B Braun/Aesculap
- Alliances
- Premier
- Inion
- Integra Orthobiologics
- Allez Spine
- Financial Performance
- B Braun Revenue, 2004-2007 (US$ Million)
- Biomet
- Alliances
- Premier
- Alphatec Holdings
- Altiva
- Financial Performance
- Biomet Revenue, 2005-2008 (US$ Million)
- Fig 19: Biomet: Spinal Revenue, 1998-2008 (US$ Million)
- Depuy
- Depuy: Recent Spinal Product Launches
- R&d Projects
- Alliances
- Alphatec Holdings
- Axial Biotech
- Archus Orthopedics
- Sinitec
- Osteotech and Lifenet
- Fziomed
- Harvest Technologies
- Djo
- Biedermann Motech Gmbh
- Legal Proceedings
- Financial Performance
- Depuy Revenue, 2004-2007 (US$ Million)
- Globus Medical
- Fig 20: Globus Medicals Revenue, 2003-2008 (US$ Million)
- Globus: Recent Product Approvals
- R&d Projects
- Medtronic
- Medtronic: Recent Spinal Product Approvals
- R&d Projects
- Alliances
- Chinese Spine and Orthopaedics Joint Venture
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Orthofix International (Blackstone Medical)
- Kensey Nash
- Aap Implantate
- Rti Biologics
- Premier
- Wyeth, Integra Orthobiologics and Astellas
- Axial Biotech
- Purdue Research Foundation
- Kyphon Agreements
- Financial Performance
- Fig 21: Medtronics Spinal Sales by Product Area, 2008
- Fig 22: Medtronics Spinal Sales by Region, 2008
- Medtronics Spinal Revenue, 2007-2008 (US$ Million)
- Fig 23: Kyphons Revenue, Y/E
- Nuvasive
- Nuvasive: Recent Product Launches
- R&d Projects
- Alliances
- Orthofix/Blackstone Medical
- Theken Spine
- Maxigen Biotech
- Tissue Banks International and Allosource
- Pearsalls
- Invibio
- Peak Industries
- Financial Performance
- Fig 24: Nuvasives Revenue, 2003-2007 (US$ Million)
- Orthofix International
- R&d Projects
- Alliances
- Musculoskeletal Transplant Foundation
- Rti Biologics
- Unitedhealth
- Nuvasive
- Innovative Spinal Technologies
- Legal Proceedings
- Financial Performance
- Orthofix Revenue by Product, 2004-2007 (US$ Million)
- Orthofix Spine Sales by Segment, 2004-2007 (US$ Million)
- Stryker
- Stryker: Recent Spinal Product Launches
- R&d Projects
- next-Generation Spinal Implants
- New Indications for Op-1
- Alliances
- Financial Performance
- Stryker Revenue, 2005-2007 (US$ Million)
- Fig 25: Stryker Sales by Product Line, 2007*
- Fig 26: Strykers Spinal Sales, 2003-2007 (US$ Million)
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Synthes
- Synthes: Recent Spinal Product Launches
- Alliances
- Innovative Spinal Technologies
- Mtf (Musculoskeletal Transplant Foundation)
- Financial Performance
- Synthes Revenue, 2004-2007 (US$ Million)
- Zimmer
- Zimmer: Recent Spinal Product Approvals
- Spinal R&d Projects
- Alliances
- U&i Corporation
- Rti Biologics
- Financial Performance
- Zimmer Revenue, 2004-2007 (US$ Million)
- Zimmer Spine Sales by Region, 2004-2007 (US$ Million)
Emerging Players
- Allez Spine
- Altiva (Exactech)
- Amedica
- Amedica: Recent Spinal Product Launches
- Anulex Technologies
- Aoi Medical
- Applied Spine Technologies
- Archus Orthopedics
- Arthrocare
- Financial Performance
- Arthrocare Revenue: 2005-2007 (US$ Million)*
- Arthro Kinetics
- Financial Performance
- Arthro Kinetics Revenue, 2005-2007 (Eur Million)*
- Atlas Spine
- Axiomed Spine
- Benvenue Medical
- Cervitech
- Co Don
- Coligne
- Corespine Technologies
- Corin
- Cryolife
- Custom Spine
- Disc Dynamics
- Disc Motion Technologies
- Dynamic Spine
- Eden Spine
- Facet Solutions
- Gentis
- Gerraspine
- Gmreis
- Impliant
- Spinal Orthopaedics: A Bright Future for New Technologies?
- Inion
- Inion Revenue, 2006-2007 (Eur Million)*
- Innovative Spinal Technologies
- Interventional Spine
- Intrinsic Therapeutics
- K2m
- K2m: Recent Product Launches
- Kensey Nash
- Ldr Holding
- Ldr: Recent Product Launches
- Life Spine
- Medicrea International
- Nexgen Spine
- Osteon
- Paradigm Spine
- Pioneer Surgical Technology
- Pioneer: Recent Product Launches
- Ranier Technology
- Raymedica
- Replication Medical
- Rsb Spine
- Scientx Revenue, 2004-2006 (US$ Million)
- Seaspine
- Signus Medizintechnik
- Sinitec
- Smart Disc
- Spinal Elements
- Spinal Kinetics
- Spinalmotion
- Spinal Restoration
- Spinemedica
- Spineology
- Spineovations
- Spinesmith
- Spinevision
- Spine Wave
- Surgicraft
- Theken Group (Integra Lifesciences)
- Theken Spine
- Theken Spine: Recent Spinal Product Approvals
- Theken Disc
- Trans1
- Financial Performance
- Trans1 Revenue, 2005-2007 (US$ Million)*
- Ulrich Medical
- US Spine
- Vertebration
- Verterbron
- Spinal Orthopaedics: A Bright Future for New Technologies?
- X-Spine
Appendices
Appendix 1 - List of Abbreviations
Appendix 2 - Report Methodology
- Secondary Sources
- Primary Sources
- Market Forecasts