Spinal Intervention: Markets for Surgical, Replacement and Neurostimulation Technologies

Spinal Intervention: Markets for Surgical, Replacement and Neurostimulation Technologies

  • January 2017
  • 181 pages
  • BCC Research
Report ID: 4579511

Use this report to:
- Measure a broad understanding of the market for spinal interventional products, as well as the markets for adjacent but complementary products and technologies.
- Analyze the market in terms of key product and technology areas, major manufacturers and factors influencing market growth.
- Provide a more comprehensive analysis of the overall market and growth opportunities for companies operating in the spinal interventional market.
- Discuss major stakeholders, product portfolios and recent developments, and to draw a competitive landscape for the market leaders in the spinal interventional market.


Highlights
- The global market for spinal and neurostimulation intervention products is expected to reach $15.8 billion by 2021 from $12.6 billion in 2016, rising at a compound annual growth rate (CAGR) of 4.5% from 2016 through 2021.
- The spinal surgery segment of spinal intervention market is the largest sector. The market is expected to grow from $9.0 billion in 2016 to $10.8 billion in 2021 at a CAGR of 3.5% for the period 2016-2021.
- The neurostimulation devices segment of spinal intervention market is expected to grow from $3.6 billion in 2016 to $5.0 billion in 2021 at a CAGR of 6.9% for the period 2016-2021.


STUDY GOALS AND OBJECTIVES
This report, Spinal Intervention: Markets for Surgical, Replacement and Neurostimulation Technologies, provides an in-depth analysis of the markets for spinal and neurostimulation products. It aims to provide readers with a broad understanding of the market for spinal interventional products, as well as the markets for adjacent but complementary products and technologies.


REASONS FOR DOING THE STUDY
In the U.S. alone, back pain has an estimated direct cost of over $50 billion annually for diagnosis, treatment and rehabilitation. Currently, it is estimated that there are approximately 65 million people in the U.S. alone with chronic back pain. The treatment of back pain depends much on the root cause. Generally, pharmaceuticals and/or physical therapy are the first-line treatments. However, should these not work, spinal surgery may be an option for some patients. Currently, over 1 million spinal surgeries are performed each year. Given the aging population, these rates are expected to continue to increase in coming years, leading to a good market opportunity for companies working in this space.

As an alternative to spinal surgery, neurostimulation has become a new option for the treatment of lower back pain in recent years. In addition to treating pain, neurostimulation can be used to treat unwanted neurological or psychological symptoms, as well as to enhance muscular activity. As such, neurostimulation can be used, or is being investigated for use, to treat a wide range of conditions, including chronic migraine, cluster headache, Parkinson’s disease, essential tremor, dystonia, epilepsy, overactive bladder, fecal incontinence, gastroparesis, obesity, gastroesophageal reflux disease, sleep apnea, treatment-resistant hypertension, obsessive-compulsive disorder, depression, heart failure, Alzheimer’s disease, tinnitus and upper-limb deficit after stroke. This is a dynamic and growing market that is attracting increasing interest from manufacturers, surgeons and patients alike.


SCOPE OF REPORT
The report provides an analysis of the markets for spinal and neurostimulation products, including trends and sales to 2021. It analyzes the market in terms of key product and technology areas, major manufacturers and factors influencing market growth.

Manufacturers of neurostimulation and spinal technologies are discussed and analyzed based on product types, market share and key corporate activities, including a mergers and acquisitions, strategic alliances, and research and development. In addition to neurostimulation products used for the treatment of spinal conditions, the report looks at the wider neurostimulation industry in order to provide a more comprehensive analysis of the overall market and growth opportunities for companies operating in this field.

The report also includes an in-depth analysis of new products and technologies in development, as well as the development of new products that can address a growing number of therapeutic indications. Excluded from the scope of the report are spinal soft goods, bracing products and externally worn neurostimulation devices.


INTENDED AUDIENCE The report is intended for anyone interested in gaining a better understanding of the spinal implant and neurostimulation markets. This may include company executives working in these areas, those planning or contemplating investing in the market, companies actively or considering pursuing market entry, component or materials manufacturers whose products may be relevant to the industry, suppliers and distributors working in this field. In addition, the report would be of interest to venture capitalists, clinicians, trade associations, research organizations and government bodies with an interest in spinal and neurostimulation products and technologies.


INFORMATION SOURCES
The information contained in the report comes from a wide range of primary and secondary sources. Financial and market data are derived from U.S. Securities and Exchange Commission filings, company annual reports and other financial reports, company investor presentations, trade associations, industry associations and company executives. Product and technology sources include company press releases and websites, information from professional organization and industry conferences, medical research papers and medical journal articles, U.S. Patent Office filings and U.S. Food and Drug Administration databases and resources, as well as similar sources available for countries other than the U.S.

Other major sources of information include government bodies such as the U.S. Center of Disease Control and Prevention, the U.S. Department of Health and Human Services and the World Health Organization, as well as similar bodies in other countries. In addition, the report has been complied with the help of direct communication with company executives, including CEOs, product managers, marketing managers, investor relations and research and development staff.


ANALYST'S CREDENTIALS Joanne Maddox is an experienced healthcare industry analyst specializing on the medical device and diagnostics markets. She has 16 years of experience working specifically in this niche area. Her work has included competitor and market insight, due diligence assistance, market forecasting and trend analysis of the medical devices industry, with a key focus on orthopedic and spinal technologies, implantable electronic devices, diagnostics, medical imaging and wound care.
CHAPTER 1
INTRODUCTION 2
STUDY GOALS AND OBJECTIVES 2
REASONS FOR DOING THE STUDY 2
SCOPE OF REPORT 2
INTENDED AUDIENCE 3
INFORMATION SOURCES 3
ANALYST'S CREDENTIALS 3
RELATED BCC RESEARCH REPORTS 4
BCC RESEARCH WEBSITE 4
DISCLAIMER 4
CHAPTER 2 SUMMARY 6
SUMMARY TABLE GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY CATEGORY, THROUGH 2021 ($ MILLIONS) 7
SUMMARY FIGURE GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY MAJOR CATEGORY, 2015-2021 ($ MILLIONS) 7
CHAPTER 3 MARKET OVERVIEW 9
TABLE 1 NUMBER OF SPINAL SURGERIES PERFORMED IN THE U.S., 2010 AND 2015 10
FIGURE 1 NUMBER OF SPINAL SURGERIES PERFORMED IN THE U.S., 2010 AND 2015 10
APPLICATIONS FOR SPINAL SURGERIES 11
DEGENERATIVE DISC DISEASE 11
SPINAL DISC HERNIATION 12
SPINAL DEFORMITY 12
SPINAL TRAUMA 13
APPLICATIONS FOR 14
TABLE 2 NEUROSTIMULATION: PREVALENCE OF ADDRESSABLE CONDITIONS IN THE U.S., 2015 (NO. OF CASES) 14
CHRONIC PAIN MANAGEMENT 14
FIGURE 2 LOCATION OF CHRONIC PAIN IN THE U.S. 15
NEUROLOGICAL DISORDERS 16
Essential Tremor 16
Parkinson's Disease 16
Dystonia 17
Epilepsy 17
Chronic Migraine and Headache 18
CARDIOVASCULAR DISEASE 18
Hypertension 18
FIGURE 3 GLOBAL RATE OF UNCONTROLLED HYPERTENSION, 1980 AND 2008 (MILLIONS) 19
Heart Failure 20
GASTROINTESTINAL DISORDERS 20
URINARY AND RECTAL DISORDERS 20
SLEEP APNEA 21
OBESITY 22
FIGURE 4 PERCENTAGE OF POPULATION WITH OBESITY IN THE U.S., 1999-2014 (%) 22
PSYCHIATRIC DISORDERS 23
CHAPTER 4 CURRENT MARKET ENVIRONMENT 26
TABLE 3 GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY CATEGORY, THROUGH 2021 ($ MILLIONS) 26
FIGURE 5 GLOBAL MARKET SHARES OF SPINAL AND NEUROSTIMULATION, BY CATEGORY, 2015 (%) 26
MAJOR MARKETS BY PRODUCT TYPE 27
SPINAL PRODUCTS 27
TABLE 4 GLOBAL MARKET FOR SPINAL DEVICES, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 28
FIGURE 6 GLOBAL MARKET SHARES OF SPINAL DEVICES, BY PRODUCT, 2015 (%) 28
NEUROSTIMULATION 29
TABLE 5 GLOBAL MARKET FOR NEUROSTIMULATION, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 29
FIGURE 7 GLOBAL MARKET SHARE OF NEUROSTIMULATION, BY PRODUCT, 2015 (%) 30
MAJOR COMPANIES AND MARKET SHARE 30
SPINAL PRODUCTS COMPETITIVE LANDSCAPE 31
TABLE 6 GLOBAL MARKET FOR SPINAL PRODUCTS, BY MAJOR COMPANIES, THROUGH 2015 ($ MILLIONS) 31
FIGURE 8 GLOBAL COMPANY MARKET SHARES OF SPINAL DEVICES, 2015 (%) 31
TABLE 7 U.S. MARKET FOR MAJOR SPINAL DEVICES, BY COMPANY, THROUGH 2015 ($ MILLIONS) 33
FIGURE 9 U.S. COMPANY MARKET SHARES OF SPINAL DEVICES, 2015 (%) 33
TABLE 8 MARKET SHARES OUTSIDE THE U.S. FOR MAJOR SPINAL DEVICES, BY COMPANY, THROUGH 2015 ($ MILLION) 34
FIGURE 10 COMPANY MARKET SHARES OUTSIDE THE U.S. FOR MAJOR SPINAL DEVICES, 2015 (%) 34
NEUROSTIMULATION PRODUCTS COMPETITIVE LANDSCAPE 35
TABLE 9 GLOBAL MARKET FOR NEUROSTIMULATION, BY MAJOR COMPANIES, THROUGH 2015 ($ MILLIONS) 36
FIGURE 11 GLOBAL MARKET SHARES OF NEUROSTIMULATION, BY MAJOR COMPANIES, 2015 (%) 36
MAJOR MARKETS BY REGION 37
THE SPINAL PRODUCTS MARKET 37
TABLE 10 GLOBAL MARKET FOR SPINAL DEVICES, BY REGION, THROUGH 2021 ($ MILLIONS) 38
FIGURE 12 GLOBAL MARKET SHARES OF SPINAL DEVICES, BY REGION, 2015 (%) 38
NEUROSTIMULATION MARKET 39
TABLE 11 GLOBAL MARKET FOR NEUROSTIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 39
FIGURE 13 GLOBAL MARKET SHARES OF NEUROSTIMULATION, BY REGION, 2015 (%) 40
MARKET TRENDS AND GROWTH DRIVERS 40
CHAPTER 5 SPINAL IMPLANT PRODUCTS AND TECHNOLOGIES 44
SPINAL FUSION 44
THE FUSION MARKET 45
TABLE 12 GLOBAL MARKET FOR SPINAL FUSION, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 46
FIGURE 14 GLOBAL MARKET SHARES OF SPINAL FUSION, BY PRODUCT, 2015 (%) 46
TABLE 13 GLOBAL MARKET FOR SPINAL FUSION, BY REGION, THROUGH 2021 ($ MILLIONS) 47
FIGURE 15 GLOBAL MARKET SHARES OF SPINAL FUSION, BY REGION, 2015 (%) 47
MATERIALS TECHNOLOGY 48
Polyetheretherketone 48
K2M's Lamellar 3D Titanium Technology 48
Orthofix International's FORZA PTC (Peek Titanium Composite) Spacer System 48
Spineart's Ti-LIFE Technology 49
Amedica's Silicon Nitride Technology 49
SeaSpine's NanoMetalene 49
B. Braun/Aesculap's PlasmaporeXP Coating 49
Zimmer Biomet's Trabecular Metal Technology 50
THORACOLUMBAR PRODUCTS 50
TABLE 14 KEY THORACOLUMBAR PRODUCTS AVAILABLE IN THE MARKET 51
New Products and Technologies 52
Alphatec Spine's Arsenal System 52
DePuy Synthes' Expedium Verse Spinal System 52
Globus Medical's Creo 53
K2M's MESA 2 Deformity Spinal System 53
K2M's Nile Alternative Fixation Spinal System 53
Medtronic's CD Horizon Fenestrated Screw Set 54
Medtronic's Vertex Reconstruction System 54
NuVasive's Integrated Global Alignment (iGA) Platform 55
INTERBODY SYSTEMS 55
TABLE 15 KEY INTERBODY PRODUCTS AVAILABLE IN THE MARKET 56
New Products and Technologies 56
Aesculap's TSpace PEEK Interbody System 56
Aesculap's ProSpaceXP Interbody System 57
Alphatec Spine's Battalion Universal Spacer System 57
Amedica's Valeo II Lateral Lumbar (LL) Interbody Fusion Device 57
Globus Medical's RISE-L 58
Globus Medical's Monument 58
Globus Medical's SILC Fixation System 59
K2M's Cascadia Products 59
Medtronic's Divergence Stand Alone Interbody Cage 60
Orthofix' Forza PTC (Peek Titanium Composite) Spacer System 60
SeaSpine's Hollywood VI NanoMetalene Interbody Device 61
Spineart's JULIETTi System 61
Spinal Elements' Expandable Interbody Fusion Devices 62
Spine Wave's Velocity L Expandable Interbody Device and XLR II Lateral Access System 62
Vertebral Body Replacements 62
Aesculap's Modulift Vertebral Body Replacement 62
K2M's Capri Corpectomy Cage System 63
NuVasive's X-Core Mini Cervical Corpectomy System 63
CERVICAL SPINAL PRODUCTS 63
DePuy Synthes' Synapse Occipital-Cervical-Thoracic System 64
K2M's Mesa Mini Spinal System and Denali Mini Spinal System 64
K2M's Pyrenees Mono Cervical Plate 65
Medtronic's DIVERGENCE System 65
Medtronic's Zevo Anterior Cervical Plate System. 66
Zimmer Biomet's Optio-C Anterior Cervical Plate 66
RTI Surgical's Streamline OCT System 67
Zimmer Biomet's Virage OCT System 67
MINIMALLY INVASIVE SPINAL FUSION 67
THE MINIMALLY INVASIVE SURGERY MARKET 68
TABLE 16 GLOBAL MARKET FOR MINIMALLY INVASIVE VS. TRADITIONAL SPINAL FUSION, THROUGH 2021 (UNIT) 68
FIGURE 16 GLOBAL MARKET SHARES OF MINIMALLY INVASIVE VS. TRADITIONAL SPINAL FUSION, 2015 (%) 69
NEW PRODUCTS AND TECHNOLOGIES 69
TABLE 17 KEY MINIMALLY INVASIVE SPINAL SURGERY PRODUCTS 70
Aesculap's S4 Element MIS System 70
LDR Holding's ROI-C Titanium-Coated Cervical Cage 71
K2M's Everest Minimally Invasive (MI) XT Spinal System 71
Medtronic's CD Horizon Solera Voyager Spinal System 72
Medtronic's Oblique Lateral Interbody Fusion Platform 72
NuVasive's Maximum Access Surgery Products 73
Orthofix International's Phoenix Minimally Invasive Spinal Fixation System 74
TOTAL DISC REPLACEMENT 74
THE TOTAL DISC REPLACEMENT MARKET 75
TABLE 18 GLOBAL MARKET FOR TOTAL DISC REPLACEMENT, BY PRODUCT, THROUGH 2021 (UNIT) 75
FIGURE 17 GLOBAL MARKET SHARES OF TOTAL DISC REPLACEMENT, BY PRODUCT, 2015 (%) 75
TABLE 19 GLOBAL MARKET FOR TOTAL DISC REPLACEMENT, BY REGION, THROUGH 2021 (UNIT) 76
FIGURE 18 GLOBAL MARKET SHARES OF TOTAL DISC REPLACEMENT, BY REGION, 2015 (%) 77
LUMBAR DISCS 77
Currently Available Products 78
Aesculap's activL Artificial Disc 78
DePuy Synthes' ProDisc-L 78
CERVICAL DISCS 79
TABLE 20 CURRENTLY AVAILABLE CERVICAL DISC REPLACEMENTS 79
Currently Available Products 80
Aesculap's Activ-C 80
DePuy Synthes' ProDisc-C 80
Clinical Data 81
Globus Medical's Secure-C 81
K2M's Rhine Cervical Disc System 81
LDR Holding's (Zimmer Biomet) Mobi-C Cervical Disc Replacement Device 82
Clinical Data 82
Medtronic's Prestige LP Cervical Disc System 83
Clinical Data 84
Spinal Kinetics' M6-C 85
DYNAMIC STABILIZATION 85
CURRENTLY AVAILABLE PRODUCTS 86
Medtronic's X-STOPPK 86
Zimmer Biomet's Dynesys Dynamic Stabilization System 86
BIOLOGICS 87
BONE GRAFT SUBSTITUTES 87
MEDTRONIC'S INFUSE BONE GRAFT 88
EUROPEAN MARKETING SUSPENSION OF MEDTRONIC'S INDUCTOS 89
DEPUY SYNTHES' VIVIGEN CELLULAR BONE MATRIX 89
SYNTHETIC BONE GRAFTS 90
Alphatec's Neocore Osteoconductive Matrix 90
NuVasive's AttraX Putty 90
Orthofix International's Trinity Evolution 91
FRACTURE REPAIR 91
THE FRACTURE REPAIR MARKET 92
TABLE 21 GLOBAL MARKET FOR SPINAL TRAUMA, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 93
FIGURE 19 GLOBAL MARKET SHARES OF SPINAL TRAUMA, BY PRODUCT, 2015 (%) 93
CURRENTLY AVAILABLE PRODUCTS 94
TABLE 22 CURRENTLY AVAILABLE TREATMENTS FOR VERTEBRAL COMPRESSION FRACTURES 94
Medtronic and Kyphon Balloon Kyphoplasty 94
Cement and Cement Delivery Systems 95
DePuy Synthes' Confidence Spinal Cement System 95
Biomet's VCF Products 95
Styker's Cortoss Bone Augmentation Material 96
Spineology's OptiMesh 96
CHAPTER 6 NEUROSTIMULATION PRODUCTS AND TECHNOLOGIES 98
TECHNOLOGICAL DEVELOPMENTS 99
MRI COMPATIBILITY 99
TABLE 23 NUMBER OF MRI SCANS PERFORMED IN THE U.S., 1995-2015 (PER 1,000 OF THE POPULATION) 100
FIGURE 20 NUMBER OF MRI SCANS PERFORMED IN THE U.S., 1995-2015 (PER 1,000 OF THE POPULATION) 100
RECHARGEABLE AND NONRECHARGEABLE DEVICES 101
SPINAL CORD STIMULATION PRODUCTS 101
CURRENT MARKET LANDSCAPE 102
TABLE 24 GLOBAL MARKET FOR SPINAL CORD STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 103
FIGURE 21 GLOBAL MARKET SHARES OF SPINAL CORD STIMULATION, BY REGION, 2015 (%) 103
USES OF SPINAL CORD STIMULATION AND COMPLEMENTARY THERAPIES 103
IMPROVED THERAPY OPTIONS 104
SPINAL CORD STIMULATION PRODUCTS ON THE MARKET 105
TABLE 25 CURRENTLY AVAILABLE SPINAL CORD STIMULATION PRODUCTS 105
RECENT SPINAL CORD STIMULATION PRODUCT LAUNCHES AND HIGHLIGHTS 107
Boston Scientific's Precision Spectra System and Illumina 3D Technology 107
Clinical Data 107
Boston Scientific's Precision Novi and MultiWave Technology 108
Boston Scientific's Precision Montage MRI System 109
Medtronic's Spinal Cord Stimulation Products 109
Nevro's Senza System and HF10 Therapy 110
Clinical Data 110
Nuvectra's Algovita System 111
St. Jude Medical's Proclaim Elite and Burst Stimulation 111
Burst Stimulation Clinical Data 112
Invisible Trial System 113
St. Jude Medical's MRI-Safe Systems 113
Stimwave Technologies' Freedom Systems 114
Freedom-8A SCS System 114
ALTERNATIVES TO TRADITIONAL SPINAL CORD STIMULATION 115
St. Jude Medical's Axium System for Dorsal Root Ganglion Stimulation 115
ACCURATE Clinical Study 115
Peripheral Nerve Stimulation 116
Stimwave's StimQ Peripheral Nerve Stimulator System 116
DEEP BRAIN STIMULATION 117
RECENT THERAPY IMPROVEMENTS AND NEW INDICATIONS FOR USE 117
THE DEEP BRAIN STIMULATION MARKET 118
TABLE 26 GLOBAL MARKET FOR DEEP BRAIN STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 118
FIGURE 22 GLOBAL MARKET SHARES OF DEEP BRAIN STIMULATION, BY REGION, 2015 (%) 118
COMPETITIVE LANDSCAPE 119
TABLE 27 CURRENTLY AVAILABLE DEEP BRAIN STIMULATION PRODUCTS 119
RECENT DEEP BRAIN STIMULATION PRODUCT LAUNCHES AND HIGHLIGHTS 121
Boston Scientific's Vercise Deep Brain Stimulation System 121
Boston Scientific's Vercise Primary Cell (PC) Deep Brain Stimulation System 121
Medtronic's Activa Systems 121
FIGURE 23 PATIENTS RECEIVING MEDTRONIC DBS THERAPY IN THE U.S. AND EUROPE, 2015, (NUMBER OF PATIENTS) 122
Expanded Approval for Parkinson's Disease Patients 122
Medtronic DBS Therapy for Refractory Epilepsy 123
Expanded Approval for Use With MRI 124
SureTune2 Software 124
TYRX Absorbable Antibacterial Envelope 124
NeuroPace's RNS System 125
Clinical Data 125
St. Jude Medical's Infinity Deep Brain Stimulation System 126
VAGUS NERVE STIMULATION 126
TABLE 28 GLOBAL MARKET FOR VAGUS NERVE STIMULATION, BY COMPANY, 2010-2015 ($ MILLIONS) 127
VAGUS NERVE STIMULATION MARKET 128
TABLE 29 GLOBAL MARKET FOR VAGUS NERVE STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 128
FIGURE 24 GLOBAL MARKET SHARES OF VAGUS NERVE STIMULATION, BY REGION, 2015 (%) 128
LIVANOVA'S VNS THERAPY 129
TABLE 30 CYBERONICS: VNS THERAPY UNIT SALES, YEAR ENDED APRIL 2010-2015 130
FIGURE 25 CYBERONICS: VNS THERAPY UNIT SALES, YEAR ENDED APRIL 2010-2015 130
FIGURE 26 CYBERONICS: SHARE OF VNS THERAPY UNIT SALES, BY REGION, YEAR ENDED APRIL 2015 (%) 130
VNS for the Treatment of Epilepsy 131
AspireSR Generator 131
VNS for the Treatment of Depression 131
Vitaria System for the Treatment of Heart Failure 132
EntroMedics' Maestro Rechargeable System and vBloc Therapy 133
Clinical Data 133
GASTRIC STIMULATION 134
MEDTRONIC'S ENTERRA THERAPY 135
INTRAPACE'S ABILITI SYSTEM 135
METACURE'S DIAMOND 136
OTHER FORMS OF NEUROSTIMULATION 136
SACRAL NERVE STIMULATION 136
Medtronic's InterStim System 136
Both products have FDA-approved labeling for 1.5 Tesla MRI head scans. 137
AORTIC BARORECEPTOR STIMULATION 137
CVRx's Barostim 138
CARDIAC CONTRACTILITY MODULATION 138
Impulse Dynamics’ Optimizer IVs 138
HYPERGLOSSAL NEUROSTIMULATION 139
Inspire Medical Systems 139
LOWER ESOPHAGEAL SPHINCTER STIMULATION THERAPY 140
EndoStim's EndoStim Therapy 141
AUTONOMIC TECHNOLOGIES AND SPHENOPALATINE GANGLION STIMULATION 141
CHAPTER 7 PRODUCT AND TECHNOLOGY PIPELINE 144
SPINAL PRODUCT PIPELINE DEVICES 144
TABLE 31 SPINAL PRODUCT PIPELINE HIGHLIGHTS 144
KEY SPINAL RESEARCH AND DEVELOPMENT PROJECTS 145
LDR Holdings' InterBRIDGE 145
LDR's New Minimal Implant Volume (MIVo) Spinal Implants 145
Amedica's 3D Printed Silicon Nitride Implants 145
RTI Surgical and Oxford Performance Materials 146
Axiomed's Freedom Lumbar Disc and Freedom Cervical Disc 146
Spinal Biologics Pipeline 147
B. Braun's TETEC Biologics Products 147
Mesoblast's MPC-06-ID 147
ISTO Technologies' NuQu Cell-Based Therapy 148
SpineOvations' DiscSeal 148
Amedica's Biologically Enhanced Implants 149
NEUROSTIMULATION PRODUCT PIPELINE 150
TABLE 32 NEUROSTIMULATION PRODUCT PIPELINE HIGHLIGHTS 150
CURRENT INDICATIONS FOR USE 151
Spinal Cord and Peripheral Nerve Stimulation 151
Neuros Medical's Altius System High Frequency Nerve Block 151
Boston Scientific and Chronic Migraine 152
Deep Brain Stimulation 152
Aleva Neurotherapeutics' Directional Deep Brain Stimulation 152
Deep Brain Innovations' Temporally Optimized Patterned Stimulation (TOPS) 153
Medtronic and Sapiens Steering Brain Stimulation 153
Vagus Nerve Stimulation 154
LivaNova's Development Pipeline 154
Enopace Biomedical's Harmony System 154
Aortic Baroreceptor Stimulation 154
CVRx's Barostim for Heart Failure 154
Hypoglossal Neurostimulation 155
ImThera Medical's THN Sleep Therapy 155
Nyxoah's Nyxoah System 156
NEW INDICATIONS AND NEUROSTIMULATION THERAPIES 156
TABLE 33 NEW INDICATIONS AND NEUROSTIMULATION THERAPIES 157
Vagus Nerve Stimulation for New Indications 157
LivaNova - Vagus Nerve Stimulation for Heart failure 157
Entromedics' Development Pipeline 158
Respicardia's remede System for Central Sleep Apnea 158
MicroTransponder's VNS Therapy for Stroke and Tinnitus 159
Vivistim System 159
Serenity System for Tinnitus 160
Neurosigma's Trigeminal Nerve Stimulation Technology 160
CHAPTER 8 INDUSTRY DEVELOPMENTS 162
MERGERS AND ACQUISITIONS 162
MERGERS AND ACQUISITIONS IN THE SPINAL PRODUCTS MARKET 162
Recent Transactions in the Spinal Products Industry 163
TABLE 34 RECENT MERGERS AND ACQUISITIONS IN THE SPINAL PRODUCTS MARKET 163
SeaSpine and NLT Spine 163
Global Medical and Alphatec Holdings’ International Operations 164
Zimmer Bioment and LDR Holding 165
Stryker and CareFusion Vertebral Compression Fracture Portfolio 165
Zimmer and Biomet 165
Globus Medical and Transplant Technologies of Texas Ltd. 165
MERGERS AND ACQUISITIONS IN THE NEUROSTIMULATION MARKET 166
Recent Transactions in the Neurostimulation Products Industry 166
TABLE 35 RECENT MERGERS AND ACQUISITIONS IN THE NEUROSTIMULATION MARKET 166
Abbott and St. Jude Medical 167
Sorin and Cyberonics 167
St. Jude Medical and Spinal Modulation 168
Medtronic and Sapiens Steering Brain Stimulation 168
Medtronic and TYRX 169
STRATEGIC ALLIANCES 169
TABLE 36 RECENT ALLIANCES IN THE MARKET 169
MAJOR AND RECENT ALLIANCES 170
Amedica and Celling Biosciences 170
RTI Surgical and Oxford Performance Materials 171
LDR Holding and Poly-Shape 171
Medtronic and Samsung Electronics America 171
DePuy Synthes and AO Foundation 172
Boston Scientific and Brainlab 172
Stimwave Technologies and Epimed International 173
LDR Holding and Sentio 174
DePuy Synthes and LifeNet Health 174
DePuy Synthes and Brainlab 174
Orthofix International and Musculoskeletal Transplant Foundation 175
Nevro, Venturi Group and the Mayo Foundation for Medical Education and Research 175
K2M and Spinal LLC 176
CHAPTER 9 COMPANY PROFILES 178
SPINAL PRODUCT MANUFACTURERS 178
ALPHATEC HOLDINGS 178
B. BRAUN/AESCULAP 179
DEPUY SYNTHES 179
GLOBUS MEDICAL 180
K2M 181
MEDTRONIC 182
NUVASIVE 183
ORTHOFIX INTERNATIONAL 183
STRYKER 184
ZIMMER BIOMET 185
NEUROSTIMULATION PRODUCT MANUFACTURERS 185
BOSTON SCIENTIFIC 185
CVRX 186
LIVANOVA 187
MEDTRONIC 188
NEUROPACE 189
NEVRO 189
ST. JUDE MEDICAL 190


LIST OF TABLES
SUMMARY TABLE GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY CATEGORY, THROUGH 2021 ($ MILLIONS) 7
TABLE 1 NUMBER OF SPINAL SURGERIES PERFORMED IN THE U.S., 2010 AND 2015 10
TABLE 2 NEUROSTIMULATION: PREVALENCE OF ADDRESSABLE CONDITIONS IN THE U.S., 2015 (NO. OF CASES) 14
TABLE 3 GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY CATEGORY, THROUGH 2021 ($ MILLIONS) 26
TABLE 4 GLOBAL MARKET FOR SPINAL DEVICES, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 28
TABLE 5 GLOBAL MARKET FOR NEUROSTIMULATION, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 29
TABLE 6 GLOBAL MARKET FOR SPINAL PRODUCTS, BY MAJOR COMPANIES, THROUGH 2015 ($ MILLIONS) 31
TABLE 7 U.S. MARKET FOR MAJOR SPINAL DEVICES, BY COMPANY, THROUGH 2015 ($ MILLIONS) 33
TABLE 8 MARKET SHARES OUTSIDE THE U.S. FOR MAJOR SPINAL DEVICES, BY COMPANY, THROUGH 2015 ($ MILLION) 34
TABLE 9 GLOBAL MARKET FOR NEUROSTIMULATION, BY MAJOR COMPANIES, THROUGH 2015 ($ MILLIONS) 36
TABLE 10 GLOBAL MARKET FOR SPINAL DEVICES, BY REGION, THROUGH 2021 ($ MILLIONS) 38
TABLE 11 GLOBAL MARKET FOR NEUROSTIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 39
TABLE 12 GLOBAL MARKET FOR SPINAL FUSION, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 46
TABLE 13 GLOBAL MARKET FOR SPINAL FUSION, BY REGION, THROUGH 2021 ($ MILLIONS) 47
TABLE 14 KEY THORACOLUMBAR PRODUCTS AVAILABLE IN THE MARKET 51
TABLE 15 KEY INTERBODY PRODUCTS AVAILABLE IN THE MARKET 56
TABLE 16 GLOBAL MARKET FOR MINIMALLY INVASIVE VS. TRADITIONAL SPINAL FUSION, THROUGH 2021 (UNIT) 68
TABLE 17 KEY MINIMALLY INVASIVE SPINAL SURGERY PRODUCTS 70
TABLE 18 GLOBAL MARKET FOR TOTAL DISC REPLACEMENT, BY PRODUCT, THROUGH 2021 (UNIT) 75
TABLE 19 GLOBAL MARKET FOR TOTAL DISC REPLACEMENT, BY REGION, THROUGH 2021 (UNIT) 76
TABLE 20 CURRENTLY AVAILABLE CERVICAL DISC REPLACEMENTS 79
TABLE 21 GLOBAL MARKET FOR SPINAL TRAUMA, BY PRODUCT, THROUGH 2021 ($ MILLIONS) 93
TABLE 22 CURRENTLY AVAILABLE TREATMENTS FOR VERTEBRAL COMPRESSION FRACTURES 94
TABLE 23 NUMBER OF MRI SCANS PERFORMED IN THE U.S., 1995-2015 (PER 1,000 OF THE POPULATION) 100
TABLE 24 GLOBAL MARKET FOR SPINAL CORD STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 103
TABLE 25 CURRENTLY AVAILABLE SPINAL CORD STIMULATION PRODUCTS 105
TABLE 26 GLOBAL MARKET FOR DEEP BRAIN STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 118
TABLE 27 CURRENTLY AVAILABLE DEEP BRAIN STIMULATION PRODUCTS 119
TABLE 28 GLOBAL MARKET FOR VAGUS NERVE STIMULATION, BY COMPANY, 2010-2015 ($ MILLIONS) 127
TABLE 29 GLOBAL MARKET FOR VAGUS NERVE STIMULATION, BY REGION, THROUGH 2021 ($ MILLIONS) 128
TABLE 30 CYBERONICS: VNS THERAPY UNIT SALES, YEAR ENDED APRIL 2010-2015 130
TABLE 31 SPINAL PRODUCT PIPELINE HIGHLIGHTS 144
TABLE 32 NEUROSTIMULATION PRODUCT PIPELINE HIGHLIGHTS 150
TABLE 33 NEW INDICATIONS AND NEUROSTIMULATION THERAPIES 157
TABLE 34 RECENT MERGERS AND ACQUISITIONS IN THE SPINAL PRODUCTS MARKET 163
TABLE 35 RECENT MERGERS AND ACQUISITIONS IN THE NEUROSTIMULATION MARKET 166
TABLE 36 RECENT ALLIANCES IN THE MARKET 169


LIST OF FIGURES
SUMMARY FIGURE GLOBAL MARKET FOR SPINAL AND NEUROSTIMULATION, BY MAJOR CATEGORY, 2015-2021 ($ MILLIONS) 7

FIGURE 1 NUMBER OF SPINAL SURGERIES PERFORMED IN THE U.S., 2010 AND 2015 10
FIGURE 2 LOCATION OF CHRONIC PAIN IN THE U.S. 15
FIGURE 3 GLOBAL RATE OF UNCONTROLLED HYPERTENSION, 1980 AND 2008 (MILLIONS) 19
FIGURE 4 PERCENTAGE OF POPULATION WITH OBESITY IN THE U.S., 1999-2014 (%) 22
FIGURE 5 GLOBAL MARKET SHARES OF SPINAL AND NEUROSTIMULATION, BY CATEGORY, 2015 (%) 26
FIGURE 6 GLOBAL MARKET SHARES OF SPINAL DEVICES, BY PRODUCT, 2015 (%) 28
FIGURE 7 GLOBAL MARKET SHARE OF NEUROSTIMULATION, BY PRODUCT, 2015 (%) 30
FIGURE 8 GLOBAL COMPANY MARKET SHARES OF SPINAL DEVICES, 2015 (%) 31
FIGURE 9 U.S. COMPANY MARKET SHARES OF SPINAL DEVICES, 2015 (%) 33
FIGURE 10 COMPANY MARKET SHARES OUTSIDE THE U.S. FOR MAJOR SPINAL DEVICES, 2015 (%) 34
FIGURE 11 GLOBAL MARKET SHARES OF NEUROSTIMULATION, BY MAJOR COMPANIES, 2015 (%) 36
FIGURE 12 GLOBAL MARKET SHARES OF SPINAL DEVICES, BY REGION, 2015 (%) 38
FIGURE 13 GLOBAL MARKET SHARES OF NEUROSTIMULATION, BY REGION, 2015 (%) 40
FIGURE 14 GLOBAL MARKET SHARES OF SPINAL FUSION, BY PRODUCT, 2015 (%) 46
FIGURE 15 GLOBAL MARKET SHARES OF SPINAL FUSION, BY REGION, 2015 (%) 47
FIGURE 16 GLOBAL MARKET SHARES OF MINIMALLY INVASIVE VS. TRADITIONAL SPINAL FUSION, 2015 (%) 69
FIGURE 17 GLOBAL MARKET SHARES OF TOTAL DISC REPLACEMENT, BY PRODUCT, 2015 (%) 75
FIGURE 18 GLOBAL MARKET SHARES OF TOTAL DISC REPLACEMENT, BY REGION, 2015 (%) 77
FIGURE 19 GLOBAL MARKET SHARES OF SPINAL TRAUMA, BY PRODUCT, 2015 (%) 93
FIGURE 20 NUMBER OF MRI SCANS PERFORMED IN THE U.S., 1995-2015 (PER 1,000 OF THE POPULATION) 100
FIGURE 21 GLOBAL MARKET SHARES OF SPINAL CORD STIMULATION, BY REGION, 2015 (%) 103
FIGURE 22 GLOBAL MARKET SHARES OF DEEP BRAIN STIMULATION, BY REGION, 2015 (%) 118
FIGURE 23 PATIENTS RECEIVING MEDTRONIC DBS THERAPY IN THE U.S. AND EUROPE, 2015, (NUMBER OF PATIENTS) 122
FIGURE 24 GLOBAL MARKET SHARES OF VAGUS NERVE STIMULATION, BY REGION, 2015 (%) 128
FIGURE 25 CYBERONICS: VNS THERAPY UNIT SALES, YEAR ENDED APRIL 2010-2015 130
FIGURE 26 CYBERONICS: SHARE OF VNS THERAPY UNIT SALES, BY REGION, YEAR ENDED APRIL 2015 (%) 130
Country=World Industry=Pathology ParentIndustry=Healthcare Date=201701 Topic=MarketReport Publisher=BCCResearch Price=5000