Spine Surgery Largely Unfazed by Recent Market Challenges

Few medical device markets have demonstrated the kind of staying power — prices, procedure growth, market growth — shown by spine surgical technologies.  The swelling caseload of new patients, the persistent clinical need and the stream of innovations from manufacturers in this arena have enabled growth rates that have not recently been seen in most other device markets.

Few medical device markets have demonstrated the kind of staying power — prices, procedure growth, market growth — shown by spine surgical technologies.  The swelling caseload of new patients, the persistent clinical need and the stream of innovations from manufacturers in this arena have enabled growth rates that have not recently been seen in most other device markets.

Of course, the market has been pinched by insurer pushback on some procedures (e.g., fusion when degenerative disc disease is involved), price pressures on some established devices and, in the U.S., regulatory reform that is long in coming.

A definite kind of demand inelasticity exists in spine disorders and trauma that has enabled it to be an area in which manufacturers have been able to succeed despite the capital restrictions and recessionary forces that have plagued markets since at least 2008.

Spine surgery technologies are comprised of the following discrete segments:

• Posterior Pedicle Screw Fusion Systems
• Anterior Cervical Plate Systems
• Anterior Thoracolumbar Plate Systems
• Anterior Lumbar Interbody Fusion (ALIF) devices
• Transforaminal Lumbar Interbody Fusion (TLIF) devices
• Posterior Lumbar Interbody Fusion (PLIF) devices
• Axial Lumbar Interbody Fusion (AxiaLIF) devices
• Interspinous Process Spacer (ISP)
• Cervical Artificial Discs
• Lumbar Artificial Discs
• Vertebroplasty
• Balloon Kyphoplasty
• Allografts
• Demineralized Bone Matrix (DBM)
• Bone Morphogenetic Proteins (BMPs)

Below is an exhibit (drawn from the 2011 MedMarket Diligence worldwide report on spine surgery) illustrating the different growth in spine surgery technology segments.

Source: MedMarket Diligence Report #M520.

Posterior pedicle screw fusion systems currently represent the largest share of the global spine technology market, a dominance that will persist through the forecast period based on its large established base. However, as is evident in the uptake of new spine technologies, there is ample opportunity for participants in all but a few sectors that are declining in absolute or relative terms.