It is estimated that approximately 50 million people in the United States (U.S.) suffer from back pain.  In 2004, more than 1 million spine surgeries were performed in the U.S.—far more than the number of hip and knee replacements combined.  Factors driving growth of the spinal surgery products market include growing numbers of people with degenerative disc disease (DDD).  DDD is typically caused by gradual disc damage and often results in disc herniation and chronic, debilitating lower back pain.  It is most common among otherwise healthy people in their 30s or 40s and affects approximately half of the U.S. population age 40 and older. 

Due to the persistence of chronic back pain despite conservative therapy, the current gold standard for the treatment of DDD is surgical intervention.  Spinal fusion is one of the most common types of spine surgery, with an estimated 380,000 procedures performed in the U.S. in 2004.  The goal of spinal fusion is to eliminate motion of the segment of the spinal column responsible for chronic back pain.  A successful spinal fusion procedure creates a permanent solid bone bridge and stability between two or more adjacent vertebrae. 

This report focuses on several core spinal fusion product areas, including:  anterior cervical plates and pedicle screw fusion devices, interbody fusion devices, bone graft substitutes and growth factors, and minimally invasive spinal surgery systems.  These products defined a U.S. spinal fusion products market worth approximately $2.3 billion in 2004.  This market is growing at a healthy annual rate of 10.7%, projected to reach more than $3.8 billion in 2009.  The largest market segment in the year 2009 will be spinal bone graft substitutes and growth factors, which cumulatively will contribute nearly $1.9 billion, or 50% of the total spinal fusion products market.  This is due to the need for a more effective alternative to painful patient autografts, and the shortage of donor bone grafts. 

This dynamic report from Medtech Insight includes analyses of current and emerging spinal fusion products and technologies and presents competitors, market forecasts, and opportunities.  Covered topics include:  anterior cervical plate systems, bone growth factors/orthobiologics, demineralized bone matrix, metallic and polymer interbody fusion devices, pedicle screw systems, structural spinal allografts, synthetic bone graft substitutes and new minimally invasive spinal surgery systems.

TABLE OF CONTENTS

EXECUTIVE SUMMARY

i.        Instrumented Spinal Fusion Devices Market

ii.       Interbody Fusion Devices Market

iii.       Bone Graft Substitutes and Growth Factors Market

iv.      Minimally Invasive Spinal Fusion

1. CLINICAL OVERVIEW

1.1   The Human Spine

1.2   Disc Herniation

1.3   Spinal Disorders

1.3.1   Degenerative Disc Disease

1.3.1.1     Facet Joint Degeneration

1.3.2 Spondylolisthesis

1.3.3   Stenosis

2. DEGENERATIVE DISC DISEASE PAIN MANAGEMENT AND TREATMENT

2.1 Nonsurgical Pain Management

2.1.1   Acupuncture

2.1.2   Bracing and Traction

2.1.2.1     Pneumatic Vests

2.1.3   Chiropractic Manipulation

2.1.4   Electrical Stimulation

2.1.4.1     Transcutaneous Electrical Nerve Stimulation

2.1.4.2     Neurostimulation

2.1.5   Intrathecal Pain Pumps

2.1.6   Nerve Block

2.1.7   Pharmaceuticals

2.1.7.1     Over-the-Counter Medications

2.1.7.2     Prescription Medications

2.1.8   Physical Therapy

2.1.8.1     McKenzie Exercises

2.1.8.2     Dynamic Lumbar Stabilization Exercises

2.2 Spine Surgery

2.2.1   Discectomy

2.2.1.1     Microdiscectomy

2.2.1.2     Microendoscopic Discectomy

2.2.1.3     Open Discectomy

2.2.1.4     Percutaneous Discectomy

2.2.1.5     IntraDiscal ElectroThermal Therapy

2.2.2   Spinal Fusion

2.2.2.1     Instrumented Fusion

2.2.2.2     Interbody Fusion
2.2.2.2.1  Anterior Lumbar Interbody Fusion
2.2.2.2.2  Posterior Lumbar Interbody Fusion
2.2.2.2.3  Transforamenal Lumbar Interbody Fusion

2.2.3   Emerging Technologies

3. INSTRUMENTED SPINAL FUSION DEVICES MARKET

3.1 Anterior Cervical Plate Systems

3.1.1   Products

3.1.1.1     Abbott Spine/Abbott Laboratories

3.1.1.2     Aesculap/B. Braun Melsungen

3.1.1.3     Alphatec Manufacturing

3.1.1.4     Altiva

3.1.1.5     ASpine USA/ASpine Holding Group

3.1.1.6     Blackstone Medical

3.1.1.7     Corin Spinal Systems/Corin Group

3.1.1.8     DePuy Spine/Johnson & Johnson

3.1.1.9     EBI/Biomet

3.1.1.10   Endius

3.1.1.11   Globus Medical

3.1.1.12   Life Spine

3.1.1.13   Medtronic Sofamor Danek/Medtronic

3.1.1.14   NuVasive

3.1.1.15   Ortho Development

3.1.1.16   OrthoTec

3.1.1.17   Scient’x/Ideal Medical Products

3.1.1.18   SeaSpine

3.1.1.19   SpineVision

3.1.1.20   Stryker Spine/Stryker

3.1.1.21   Synthes

3.1.1.22   Theken Spine

3.1.1.23   VERTEBRON

3.1.1.24   Zimmer

3.1.2   Market Analysis

3.1.3   Competitive Analysis

3.2 Pedicle Screw Systems

3.2.1   Products

3.2.1.1     Abbott Spine/Abbott Laboratories

3.2.1.2     Advanced Medical Technologies AG

3.2.1.3     Aesculap/B. Braun Melsungen

3.2.1.4     Alphatec Manufacturing

3.2.1.5     ASpine USA/ASpine Holding Group

3.2.1.6     Blackstone Medical

3.2.1.7     Co-Ligne

3.2.1.8     Corin Spinal Systems/Corin Group

3.2.1.9     DePuy Spine/Johnson & Johnson

3.2.1.10   EBI/Biomet

3.2.1.11   Encore Medical

3.2.1.12   Endius

3.2.1.13   Globus Medical

3.2.1.14   Innovasis

3.2.1.15   Medtronic Sofamor Danek/Medtronic

3.2.1.16   NAS Medical Technologies

3.2.1.17   NuVasive

3.2.1.18   Ortho Development

3.2.1.19   OrthoTec

3.2.1.20   Scient’x/Ideal Medical Products

3.2.1.21   SeaSpine

3.2.1.22   SpineVision

3.2.1.23   Stryker Spine/Stryker

3.2.1.24   Synthes

3.2.1.25   Theken Spine

3.2.1.26   VERTEBRON

3.2.1.27   Zimmer

3.2.2   Market Analysis

3.2.3   Competitive Analysis

4. INTERBODY FUSION DEVICES MARKET

4.1 Metallic Interbody Fusion Devices

4.1.1   Abbott Spine/Abbott Laboratories

4.1.2   Aesculap/B. Braun Melsungen

4.1.3   Alphatec Manufacturing

4.1.4   Biorthex

4.1.5   Corin Spinal Systems/Corin Group

4.1.6   EBI/Biomet

4.1.7   Medtronic Sofamor Danek/Medtronic

4.1.8   Scient’x/Ideal Medical Products

4.1.9   Signus Medical

4.1.10 Stryker Spine/Stryker

4.1.11 Theken Spine

4.1.12 Zimmer Spine/Zimmer

4.2 Polyme Interbody Fusion Devices

4.2.1   Abbott Spine/Abbott Laboratories

4.2.2   Blackstone Medical

4.2.3   DePuy Spine/Johnson & Johnson

4.2.4   EBI/Biomet

4.2.5   Globus Medical

4.2.6   Scient’x/Ideal Medical Products

4.2.7   Spinevision

4.2.8   Stryker Spine/Stryker

4.2.9   Surgicraft

4.2.10 Theken Spine

4.2.11 Zimmer Spine/Zimmer

4.3 Structural Spinal Allografts

4.3.1   Abbott Spine/Abbott Laboratories

4.3.2   Aesculap/B. Braun Melsungen

4.3.3   Cortek

4.3.4   DePuy Spine/Johnson & Johnson

4.3.5   EBI/Biomet

4.3.6   Endius

4.3.7   Medtronic Sofamor Danek/Medtronic

4.3.8   Osteotech

4.3.9   Stryker Spine/Stryker

4.3.10 Synthes

4.3.11 VERTEBRON

4.3.12 Zimmer Spine/Zimmer

4.4 Market Analysis

4.4.1   Metallic and Polymer Interbody Fusion Devices

4.4.2   Structural Spinal Allografts

4.5 Competitive Analysis

4.5.1   Metallic and Polymer Interbody Fusion Devices

4.5.2   Structural Spinal Allografts

5. BONE GRAFT SUBSTITUTES AND GROWTH FACTORS MARKET

5.1 Demineralized Bone Matrix

5.1.1   AlloSource

5.1.2   DePuy Spine/Johnson & Johnson

5.1.3   IsoTis OrthoBiologics/IsoTis

5.1.4   Medtronic Sofamor Danek/Medtronic

5.1.5   Osteotech

5.1.6   Therics, LLC/Theken

5.2 Synthetic Bone Graft Substitutes

5.2.1   Abbott Spine/Abbott Laboratories

5.2.2   Biocomposites

5.2.3   DePuy Spine/Johnson & Johnson

5.2.4   EBI/Biomet

5.2.5   IsoTis OrthoBiologics/IsoTis

5.2.6   Medtronic Sofamor Danek/Medtronic with ETEX

5.2.7   NeuColl/Angiotech Pharmaceuticals

5.2.8   Orthovita

5.2.9   Smith & Nephew

5.2.10 Synthes

5.2.11 Therics, LLC/Theken

5.2.12 Wright Medical Technology

5.3 Bone Growth Factors/Orthobiologics

5.3.1   DePuy Spine/Johnson & Johnson

5.3.2   Medtronic Sofamor Danek/Medtronic

5.3.3   OrthoLogic

5.3.4   Pfizer

5.3.5   Stryker Biotech/Stryker

5.3.6   Wyeth Pharmaceuticals/Wyeth

5.4 Autologous Growth Factors

5.4.1   DePuy Spine/Johnson & Johnson with Harvest Technologies

5.4.2   EBI/Biomet

5.5 Market Analysis

5.5.1   Bone Graft Substitutes

5.5.2   Bone Growth Factors/Orthobiologics

5.6 Competitive Analysis

5.6.1   Bone Graft Substitutes

5.6.2   Bone Growth Factors/Orthobiologics

6. MINIMALLY INVASIVE SPINAL FUSION PRODUCTS MARKET

6.1 Products

6.1.1   Abbott Spine

6.1.2   DePuy Spine/Johnson & Johnson

6.1.3   EBI/Biomet

6.1.4   Endius

6.1.5   Medtronic Sofamor Danek/Medtronic

6.1.6   NuVasive, Inc.

6.1.7   TranS1

6.2 Market Analysis

6.3 Competitive Analysis

7. COMPANY PROFILES

7.1   Abbott Spine, Inc./Abbott Laboratories

7.2   Aesculap, Inc./B. Braun Melsungen AG

7.3   DePuy Spine, Inc./Johnson & Johnson

7.4   EBI LP/Biomet, Inc.

7.5   Endius, Inc.

7.6   Medtronic Sofamor Danek, Inc./Medtronic, Inc.

7.7   NuVasive, Inc.

7.8   Osteotech, Inc.

7.9   Stryker Spine/Stryker Corporation

7.10 Synthes AG

7.11 Theken Group LLC

7.12 TranS1, Inc.

7.13 Zimmer Spine, Inc./Zimmer, Inc.

APPENDIX:  COMPANY LISTING

LIST OF EXHIBITS

Exhibit ES-1:  U.S. Spinal Fusion Products, Market Forecast, by Segment, 2004-2009

Exhibit ES-2:  Anterior Cervical Plates, Market Forecast, 2004-2009

Exhibit ES-3:  Pedicle Screw Systems, Market Forecast, 2004-2009

Exhibit ES-4:  Interbody Fusion Devices, Market Forecast, 2004-2009

Exhibit ES-5:  Structural Spinal Allografts, Market Forecast, 2004-2009

Exhibit ES-6:  Spinal Bone Graft Substitutes, Market Forecast, 2004-2009

Exhibit ES-7:  Spinal Bone Growth Factors/Orthobiologics, Market Forecast, 2004-2009

Exhibit ES-8:  Minimally Invasive Spinal Fusion Systems, Market Forecast, 2004-2009

Exhibit 2-1:    Methods of Lumbar Fusion

Exhibit 3-1:    2005, Selected Anterior Cervical Plate Systems

Exhibit 3-2:    Anterior Cervical Plates, Market Forecast,  2004-2009

Exhibit 3-3:    2004, Anterior Cervical Plates Market, Share by Supplier

Exhibit 3-4:    2005, Selected Pedicle Screw Systems

Exhibit 3-5:    Pedicle Screw Systems, Market Forecast,  2004-2009

Exhibit 3-6:    2004, Pedicle Screw Systems Market, Share by Supplier

Exhibit 4-1:    2005, Selected Metallic Interbody Fusion Devices

Exhibit 4-2:    2005, Selected Polymer Interbody Fusion Devices

Exhibit 4-3:    2005, Selected Structural Spinal Allografts

Exhibit 4-4:    Interbody Fusion Devices, Market Forecast, 2004-2009

Exhibit 4-5:    Structural Spinal Allografts, Market Forecast, 2004-2009

Exhibit 4-6:    2004, Interbody Fusion Devices Market, Share by Supplier

Exhibit 4-7:    2004, Structural Spinal Allograft Market, Share by Supplier

Exhibit 5-1:    2005, Selected Demineralized Bone Matrix

Exhibit 5-2:    2005, Selected Synthetic Bone Graft Substitutes

Exhibit 5-3:    2005, Selected Bone Growth Factors/Orthobiologics

Exhibit 5-4:    2005, Selected Autologous Growth Factors

Exhibit 5-5:    Spinal Bone Graft Substitutes, Market Forecast, 2004-2009

Exhibit 5-6:    Spinal Bone Growth Factors/Orthobiologics, Market Forecast, 2004-2009

Exhibit 5-7:    2004, Spinal Bone Graft Substitutes Market, Share by Supplier

Exhibit 5-8:    2004, Spinal Bone Growth Factors/Orthobiologics Market, Share by Supplier

Exhibit 6-1:    2005, Selected Minimally Invasive Spinal Surgery Systems

Exhibit 6-2:    Minimally Invasive Spinal Fusion Systems, Market Forecast, 2004-2009

Exhibit 6-3:    2004, Minimally Invasive Spinal Fusion Systems Market, Share
                   by Supplier

Copyright 2005, Medtech Insight, LLC