Spinal fusion is a surgical procedure that stabilizes the vertebrae to alleviate debilitating pain caused by a degenerated disc after conservative treatments have failed.  Spinal fusion surgery uses bone graft to enable two opposing vertebrae to fuse, or weld together.  For further support, spinal instruments (or permanent implants) such as metallic plates, rods, and screws help join the vertebrae together to restore spinal stability.  These implants help correct deformity and bridge spaces created by the removal of damaged spinal elements, such as herniated discs.

In 2005, it is estimated that more than 150,000 spinal fusion procedures were performed in the five (5) largest healthcare markets in Europe (France, Germany, Italy, Spain and the United Kingdom).  European spinal fusion surgery utilizes traditional spinal fixation instrumentation—including pedicle screw systems, anterior cervical plates and interbody fusion devices, or “cages.”  In 2005, this device market is estimated to have generated more than $350 million in product sales.  The market for bone graft substitutes and growth factors is estimated to have totaled only $13 million in 2005, due to the conservative use of such materials, particularly allografts. 

Although the European spinal fusion products market is smaller and more conservative than the U.S., it is expected to increase nearly $100 million over the next five years, growing at a steady compound annual rate of approximately 5%, totaling approximately $470 million in the year 2010.  Growth will be due to improved surgeon training and adaptation, an increase in the number of aging European patients with degenerative disc disease, and more aggressive marketing from multinational spinal device firms. 

This dynamic report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the European market for spinal fusion products. 

Covered topics in this report include: spinal fixation devices, including pedicle screw systems, anterior cervical plates, and metallic and polymer interbody fusion devices/cages; bone graft substitutes, including demineralized bone matrix and synthetic bone graft substitutes; and bone growth factors, or orthobiologics.  Healthcare profiles are provided for France, Germany, Italy Spain and the United Kingdom.

TABLE OF CONTENTS AND LIST OF EXHIBITS

EXECUTIVE SUMMARY

i.      Spinal Fusion Devices and Instrumentation

ii.     Pedicle Screw Systems

iii.    Anterior Cervical Plates

iv.    Interbody Fusion Devices

v.     Bone Graft Substitutes

vi.    Bone Growth Factors

vii.   Total Spinal Fusion Products Market

viii.   Methodology

Exhibit ES-1:  Stages of Disc Herniation

Exhibit ES-2:  Europe, Spinal Fusion Devices, Market Forecast, by Country, 2004-2010

Exhibit ES-3:  Europe, Spinal Fusion Devices, Market Forecast, by Market Segment, 2004-2010

Exhibit ES-4:  Europe, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit ES-5:  Europe, Anterior Cervical Plate Systems, Market Forecast, 2004-2010

Exhibit ES-6:  Europe, Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit ES-7:  Europe, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit ES-8:  Europe, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit ES-9:  Europe, Spinal Fusion Products, Combined Market Forecast, by Segment, 2004-2010

1. CLINICAL OVERVIEW OF SPINAL DISORDERS

1.1 Anatomy of the Human Spine

1.1.1 Vertebrae

1.1.2 Intervertebral Discs

1.1.3 Spinal Cord

1.2 Bone Physiology and Remodeling

1.3 Spinal Disorders

1.3.1 Degenerative Disorders

1.3.1.1 Degenerative Disc Disease

1.3.1.2 Herniated Disc

1.3.1.3 Spinal Stenosis

1.3.1.4 Spondylosis

1.3.1.5 Spondylolisthesis

1.3.1.6 Osteoporosis

1.3.1.7 Rheumatoid Arthritis

1.3.1.8 Paget’s Disease

1.3.2 Spinal Trauma

1.3.3 Deformity Disorders

1.3.3.1 Scoliosis

1.3.3.2 Kyphosis

1.3.3.3 Lordosis

1.3.3.4 Spinal Tumors

1.3.3.5 Malignant Spinal Tumors

1.3.3.6 Benign Spinal Tumors

Exhibit 1-1:    The Human Spine

Exhibit 1-2:    Spinal Column Segment

Exhibit 1-3:    Spinal Disc

Exhibit 1-4:    Degenerative Spinal Disorders

Exhibit 1-5:    Stages of Disc Herniation

Exhibit 1-6:    Spinal Stenosis

Exhibit 1-7:    Spondylolisthesis

Exhibit 1-8:    Vertebral Compression Fracture

Exhibit 1-9:    Scoliosis

Exhibit 1-10:  Kyphosis

Exhibit 1-11:  Lordosis

2. EUROPEAN HEALTHCARE MARKETS

2.1 The European Union

2.1.1 The Euro Zone

2.1.2 Regulatory Policies

2.1.3 Reimbursement

2.1.4 Healthcare Spending and Reform

2.1.5 Intercountry Patient Movement

2.2 Selected European National Healthcare Profiles

2.2.1 France

2.2.2 Germany

2.2.3 Italy

2.2.4 Spain

2.2.5 United Kingdom

Exhibit 2-1:    Public Healthcare Expenditures, 2000-2003

Exhibit 2-2:    Private Healthcare Expenditures, 2000-2003

Exhibit 2-3:    Total Per Capita Healthcare Expenditures, 2000-2003

Exhibit 2-4:    Practicing Physicians, 2000-2004

Exhibit 2-5:    Percentage of Practicing Physicians, 2000-2004

Exhibit 2-6:    Number of Acute Care Beds per 1,000 Population, 2000-2004

Exhibit 2-7:    Total Population, by Country, 2000-2004

Exhibit 2-8:    2004, France, Selected Healthcare Statistics

Exhibit 2-9:    2004, Germany, Selected Healthcare Statistics

Exhibit 2-10:  2004, Italy, Selected Healthcare Statistics

Exhibit 2-11:  2004, Spain, Selected Healthcare Statistics

Exhibit 2-12:  2004, United Kingdom, Selected Healthcare Statistics

3. SPINAL FUSION DEVICES AND INSTRUMENTATION

3.1 Pedicle Screw Systems

3.1.1 Abbott Spine/Abbott Laboratories

3.1.2 Aesculap/B. Braun Melsungen

3.1.3 ASpine USA/ASpine Holding Group

3.1.4 Biomet Europe/Biomet

3.1.5 Blackstone Medical

3.1.6 coLigne

3.1.7 DePuy Spine/Johnson & Johnson

3.1.8 Fixano/Viscogliosi Brothers

3.1.9 Kiscomedica

3.1.10 LDR Médical

3.1.11 Medicrea Technologies/Medicrea International

3.1.12 Medtronic Sofamor Danek/Medtronic

3.1.13 Ortho Development

3.1.14 Scient’X/Ideal Medical Products

3.1.15 Signus Medizintechnik

3.1.16 Sintea Biotech

3.1.17 SpineNetwork

3.1.18 SpineVision

3.1.19 Stryker Spine/Stryker

3.1.20 Synthes

3.1.21 Ulrich Medical

3.1.22 VERTEBRON

3.1.23 Zimmer Spine/Zimmer

3.2 Anterior Cervical Plate Systems

3.2.1 Abbott Spine/Abbott Laboratories

3.2.2 Aesculap/B. Braun Melsungen

3.2.3 ASpine USA/ASpine Holding Group

3.2.4 Biomet Europe/Biomet

3.2.5 Blackstone Medical

3.2.6 DePuy Spine/Johnson & Johnson

3.2.7 Fixano/Viscogliosi Brothers

3.2.8 Inion

3.2.9 Medtronic Sofamor Danek/Medtronic

3.2.10 Ortho Development

3.2.11 Scient’X/Ideal Medical Products

3.2.12 Signus Medizintechnik

3.2.13 Sintea Biotech

3.2.14 SpineNetwork

3.2.15 SpineVision

3.2.16 Stryker Spine/Stryker

3.2.17 Synthes

3.2.18 Ulrich Medical

3.2.19 VERTEBRON

3.2.20 Zimmer Spine/Zimmer

3.3 Interbody Fusion Devices

3.3.1 Metallic Interbody Fusion Devices

3.3.1.1 Abbott Spine/Abbott Laboratories

3.3.1.2 Aesculap/B. Braun Melsungen

3.3.1.3 Biomet Europe/Biomet

3.3.1.4 Biorthex

3.3.1.5 Disc-O-Tech Medical Technologies

3.3.1.6 Medtronic Sofamor Danek/Medtronic

3.3.1.7 Scient’X/Ideal Medical Products

3.3.1.8 Signus Medizintechnik

3.3.1.9 Sintea Biotech

3.3.1.10 Stryker Spine/Stryker

3.3.1.11 Synthes

3.3.1.12 Ulrich Medical

3.3.1.13 Zimmer Spine/Zimmer

3.3.2 Polymer Interbody Fusion Devices

3.3.2.1 Abbott Spine/Abbott Laboratories

3.3.2.2 Biomet Europe/Biomet

3.3.2.3 Blackstone Medical

3.3.2.4 DePuy Spine/Johnson & Johnson

3.3.2.5 LDR Médical

3.3.2.6 MacroPore Biosurgery/Cytori Therapeutics

3.3.2.7 Scient’X/Ideal Medical Products

3.3.2.8 Signus Medizintechnik

3.3.2.9 SpineVision

3.3.2.10 Stryker Spine/Stryker

3.3.2.11 Surgicraft

3.3.2.12 Zimmer Spine/Zimmer

3.3.3 Structural Spinal Allografts

3.3.3.1 Abbott Spine/Abbott Laboratories

3.3.3.2 DePuy Spine/Johnson & Johnson

3.3.3.3 Medtronic Sofamor Danek/Medtronic

3.3.3.4 Osteotech

3.3.3.5 VERTEBRON

3.4 Market Analysis

3.4.1 Pedicle Screw Systems

3.4.2 Anterior Cervical Plates

3.4.3 Interbody Fusion Devices

3.4.4 Total Spinal Fusion Devices and Instrumentation Market

3.5 Competitive Analysis

3.5.1 Pedicle Screws Systems and Anterior Cervical Plates

3.5.2 Interbody Fusion Devices

Exhibit 3-1:    2006, Selected Pedicle Screw Systems

Exhibit 3-2:    2006, Selected Anterior Cervical Plate Systems

Exhibit 3-3:    2006, Selected Metallic Interbody Fusion Devices

Exhibit 3-4:    2006, Selected Polymer Interbody Fusion Devices

Exhibit 3-5:    2006, Selected Structural Spinal Allografts

Exhibit 3-6:    France, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-7:    Germany, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-8:    Italy, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-9:    Spain, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-10:  United Kingdom, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-11:  Europe, Pedicle Screw Systems, Market Forecast, 2004-2010

Exhibit 3-12:  France, Anterior Cervical Plates, 2004-2010

Exhibit 3-13:  Germany, Anterior Cervical Plates, 2004-2010

Exhibit 3-14:  Italy, Anterior Cervical Plates, 2004-2010

Exhibit 3-15:  Spain, Anterior Cervical Plates, 2004-2010

Exhibit 3-16:  United Kingdom, Anterior Cervical Plates, 2004-2010

Exhibit 3-17:  Europe, Anterior Cervical Plate Systems, Market Forecast, 2004-2010

Exhibit 3-18:  France, Cervical Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-19:  Germany, Cervical Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-20:  Italy, Cervical Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-21:  Spain, Cervical Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-22:  United Kingdom, Cervical Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-23:  France, Thoracolumbar Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-24:  Germany, Thoracolumbar Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-25:  Italy, Thoracolumbar Interbody Fusion Devices,Market Forecast, 2004-2010

Exhibit 3-26:  Spain, Thoracolumbar Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-27:  United Kingdom, Thoracolumbar Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-28:  Europe, Interbody Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-29:  Europe, Spinal Fusion Devices, Market Forecast, by Country, 2004-2010

Exhibit 3-30:  Europe, Spinal Fusion Devices, Market Forecast, by Market Segment, 2004-2010

Exhibit 3-31:  France, Spinal Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-32:  Germany, Spinal Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-33:  Italy, Spinal Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-34:  Spain, Spinal Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-35:  United Kingdom, Spinal Fusion Devices, Market Forecast, 2004-2010

Exhibit 3-36:  2005, Europe, Pedicle Screws and Anterior Cervical Plates Market, Share by Supplier

Exhibit 3-37:  2005, Europe, Interbody Fusion Devices Market, Share by Supplier

4. BONE GRAFT SUBSTITUTES AND GROWTH FACTORS

4.1 Demineralized Bone Matrix

4.1.1 DePuy Spine/Johnson & Johnson

4.1.2 IsoTis OrthoBiologics/IsoTis

4.1.3 Medtronic Sofamor Danek/Medtronic

4.1.4 Osteotech

4.2 Synthetic Bone Graft Substitutes

4.2.1 Abbott Spine/Abbott Laboratories

4.2.2 Biomet Europe/Biomet

4.2.3 DePuy Spine/Johnson & Johnson

4.2.4 IsoTis OrthoBiologics/IsoTis

4.2.5 LDR Médical

4.2.6 Medtronic Sofamor Danek/Medtronic

4.2.7 NeuColl/Angiotech Pharmaceuticals

4.2.8 Orthovita

4.2.9 OsteoBiologics

4.2.10 Smith & Nephew

4.2.11 Synthes

4.2.12 Wright Medical Technology

4.3 Bone Growth Factors and Orthobiologics

4.3.1 DePuy Spine/Johnson & Johnson

4.3.2 Medtronic Sofamor Danek/Medtronic

4.3.3 OrthoLogic

4.3.4 Pfizer

4.3.5 Stryker Biotech/Stryker

4.4 Market Analysis

4.4.1 Bone Graft Substitutes

4.4.2 Bone Growth Factors/Orthobiologics

4.5 Competitive Analysis

4.5.1 Bone Graft Substitutes

4.5.2 Bone Growth Factors/Orthobiologics

Exhibit 4-1:    2006, Selected Demineralized Bone Matrix

Exhibit 4-2:    2006, Selected Synthetic Bone Graft Substitutes

Exhibit 4-3:    2006, Selected Bone Growth Factors/Orthobiologics

Exhibit 4-4:    France, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-5:    Germany, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-6:    Italy, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-7:    Spain, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-8:    United Kingdom, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-9:    Europe, Bone Graft Substitutes, Market Forecast, 2004-2010

Exhibit 4-10:  France, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-11:  Germany, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-12:  Italy, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-13:  Spain, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-14:  United Kingdom, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-15:  Europe, Bone Morphogenetic Proteins, Market Forecast, 2004-2010

Exhibit 4-16:  2005, Europe, Bone Graft Substitutes Market, Share by Supplier filed Companies

5. COMPANY PROFILES

5.1   Abbott Spine, Inc./Abbott Laboratories

5.2   Aesculap AG & Company KG/B. Braun Melsungen AG

5.3   Biomet Europe/Biomet, Inc.

5.4   DePuy Spine, Inc./Johnson & Johnson

5.5   Inion Oy

5.6   LDR Médical

5.7   Medtronic Sofamor Danek, Inc./Medtronic, Inc.

5.8   Osteotech, Inc.

5.9   Scient’X SA/Ideal Medical Products

5.10 Stryker SA/Stryker Corporation

5.11 Synthes AG

5.12 Zimmer Spine, Inc./Zimmer Holdings, Inc.

APPENDIX:  COMPANY LISTING

Copyright 2006, Medtech Insight, LLC