An estimated 30 million people in the largest European Union (EU) countries of France, Germany, Italy, Spain and the United Kingdom suffer from back pain and over 150,000 invasive spinal fusions are performed annually. There is great demand for safer, more effective alternatives to spinal fusion, which has a ten-year reoperation rate of approximately 10%.  Several new promising spinal motion-preserving technologies have emerged, including artificial discs, nucleus replacements and dynamic stabilization.  Total disc replacements (TDRs) may restore proper disc height, allow for full range of motion, and provide stability and weight bearing capabilities better than spinal fusion.  In 2005, the TDR market in the five largest European Union (EU) countries (France, Germany, Italy, Spain and the United Kingdom) was estimated at approximately $58 million.  This market is expected to grow at a compound annual rate of approximately 18%, reaching an estimated $132.3 million in 2010.  Research also is currently under way to create artificial replacement materials, such as hydrogels and various polymers, to replace the disc’s nucleus pulposa.  The nucleus replacement segment is currently very small in the EU (estimated at approximately $1 million) due to its emerging status, but may expand significantly over the next decade.  Dynamic stabilization motion preserving devices, in contrast, have been used in Europe for more than 10 years and support the spine from the posterior side, and leave the disc intact without fusing the vertebrae.  The EU dynamic stabilization market totaled approximately $26 million in 2005 and has the potential to grow to a $65 million market in five years, increasing at a compound annual rate of 20%. 

The vertebral compression fractures market is also an important growth area, primarily due to the increase in osteoporosis in the EU.  Minimally invasive vertebroplasty and kyphoplasty systems totaled an estimated $39 million market in 2005; this segment is the second-largest spinal motion-preserving segment, and is forecast to increase at a compound annual rate of approximately 24%, reaching a substantial market of nearly $115 million in 2010.

This dynamic report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the largest EU countries (France, Germany, Italy, Spain and the United Kingdom) for spinal motion preserving devices. Covered topics in this report include: cervical artificial discs, lumbar artificial discs, nucleus replacements, dynamic stabilization systems, vertebroplasty and kyphoplasty systems. 

TABLE OF CONTENTS AND LIST OF EXHIBITS

EXECUTIVE SUMMARY

i.   Artificial Spinal Discs and Nucleus Replacement Products

ii.   Dynamic Stabilization Devices

iii.  Vertebral Compression Fracture Products

iv.  Total European Spinal Motion-Preserving Devices Market

v.  Methodology

Exhibit ES-1:    Stages of Disc Herniation

Exhibit ES-2:    Differentiating Features of First-Generation Total Disc Replacements

Exhibit ES-3:    Important Mechanical Properties of Artificial Discs

Exhibit ES-4:    Types of Artificial Disc Replacements

Exhibit ES-5:    Europe, Artificial Cervical and Lumbar Discs, Combined Market Forecast, 2004-2010

Exhibit ES-6:    Europe, Artificial Discs and Nucleus Replacement Products, Combined Market Forecast,  2004-2010

Exhibit ES-7:    Anatomic Changes Achieved by Dynamic Stabilization Devices

Exhibit ES-8:    Europe, Dynamic Stabilization Devices, Market Forecast, 2004-2010

Exhibit ES-9:    Comparison of Vertebral Compression Fracture Treatments

Exhibit ES-10:   Europe, Vertebroplasty and Kyphoplasty Systems, Combined Market Forecast, 2004-2010

Exhibit ES-11:   Europe, Spinal Motion-Preserving Devices, 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. ARTIFICIAL SPINAL DISCS AND NUCLEUS REPLACEMENT PRODUCTS

3.1 Artificial Cervical Discs

3.1.1 Abbott Spine/Abbott Laboratories

3.1.2 Cervitech

3.1.3 EBI/Biomet

3.1.4 Globus Medical

3.1.5 LDR Spine/LDR Médical

3.1.6 Medtronic Sofamor Danek/Medtronic

3.1.7 NuVasive

3.1.8 Scient’x/Ideal Medical Products

3.1.9 Spinal Kinetics

3.1.10 SpinalMotion

3.1.11 Stryker Spine/Stryker

3.1.12 Synthes

3.1.13 VERTEBRON

3.1.14 X-spine Systems

3.2 Artificial Lumbar Discs

3.2.1 Abbott Spine/Abbott Laboratories

3.2.2 Aesculap/B. Braun Melsungen

3.2.3 AxioMed Spine

3.2.4 DePuy Spine/Johnson & Johnson

3.2.5 EBI/Biomet

3.2.6 LDR Spine/LDR Médical

3.2.7 Medtronic Sofamor Danek/Medtronic

3.2.8 Ranier Technology

3.2.9 SpinalMotion

3.2.10 Stryker Spine/Stryker

3.2.11 Synthes

3.2.12 Theken Disc/Theken Group

3.2.13 US Spine/U.S. Spinal Technologies

3.2.14 VERTEBRON

3.3 Nucleus Replacement Products

3.3.1 Corin Spinal Systems/Corin Group

3.3.2 CryoLife

3.3.3 Disc Dynamics

3.3.4 Dynamic Spine

3.3.5 EBI/Biomet

3.3.6 Medtronic Sofamor Danek/Medtronic

3.3.7 Pioneer Surgical Technology

3.3.8 Raymedica/Viscogliosi Brothers

3.3.9 Replication Medical

3.3.10 SpineMedica

3.3.11 Spine Wave

3.3.12 Stryker Spine/Stryker

3.3.13 Synthes

3.3.14 Zimmer

3.4 Market Analysis

3.4.1 Artificial Cervical Discs

3.4.2 Artificial Lumbar Discs

3.4.3 Nucleus Replacement Products

3.4.4 Total European Spinal Artificial Discs and Nucleus Replacement Products Market

3.5 Competitive Analysis

3.5.1 Artificial Cervical Discs

3.5.2 Artificial Lumbar Discs

3.5.3 Nucleus Replacement Products

Exhibit 3-1:    Differentiating Features of First-Generation Total Disc Replacements

Exhibit 3-2:    Important Mechanical Properties of Artificial Discs

Exhibit 3-3:    Types of Artificial Disc Replacements

Exhibit 3-4:    2006, Selected Artificial Cervical Discs Available in Europe

Exhibit 3-5:    2006, Selected Artificial Cervical Discs in Clinical Trials

Exhibit 3-6:    2006, Selected First-Generation Artificial Lumbar Discs

Exhibit 3-7:    2006, Selected Artificial Lumbar Discs Available in Europe

Exhibit 3-8:    2006, Selected Artificial Lumbar Discs in Clinical Trials

Exhibit 3-9:    Comparison of AxioMed Spine’s Freedom Lumbar Disc with First-Generation Disc Replacement Technology

Exhibit 3-10:  Degenerative Changes Following Discectomy

Exhibit 3-11:  Potential Benefits of Partial Nucleus Replacement

Exhibit 3-12:  2006, Selected Nucleus Replacement Products

Exhibit 3-13:  Potential Benefits of Disc Dynamics’ DASCOR Disc Arthroplasty System

Exhibit 3-14:  Properties of Spine Wave’s NuCore Injectable Disc Nucleus

Exhibit 3-15:  France, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-16:  Germany, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-17:  Italy, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-18:  Spain, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-19:  United Kingdom, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-20:  Europe, Artificial Cervical Discs, Market Forecast, 2004-2010

Exhibit 3-21:  France, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-22:  Germany, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-23:  Italy, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-24:  Spain, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-25:  United Kingdom, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-26:  Europe, Artificial Lumbar Discs, Market Forecast, 2004-2010

Exhibit 3-27:  France, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-28:  Germany, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-29:  Italy, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-30:  Spain, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-31:  United Kingdom, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-32:  Europe, Nucleus Replacement Products, Market Forecast, 2004-2010

Exhibit 3-33:  Europe, Artificial Cervical and Lumbar Discs, Combined Market Forecast, 2004-2010

Exhibit 3-34:  Europe, Artificial Discs and Nucleus Replacements, Combined Market Forecast, 2004-2010

Exhibit 3-35:  2005, Artificial Cervical Discs Market, Share by Supplier

Exhibit 3-36:  2005, Artificial Lumbar Discs Market, Share by Supplier

Exhibit 3-37:  2005, Nucleus Replacement Products Market, Share by Supplier

4. DYNAMIC STABILIZATION DEVICES

4.1 Types of Devices

4.1.1 Indications

4.1.2 Interspinous Process Spacers

4.1.2.1 Abbott Spine/Abbott Laboratories

4.1.2.2 Biomet Europe/Biomet

4.1.2.3 Medtronic Sofamor Danek/Medtronic

4.1.2.4 Paradigm Spine/Viscogliosi Brothers

4.1.2.5 St. Francis Medical Technologies

4.1.3 Posterior Dynamic Stabilization Systems

4.1.3.1 Abbott Spine/Abbott Laboratories

4.1.3.2 Applied Spine Technologies

4.1.3.3 Globus Medical

4.1.3.4 Innovative Spinal Technologies

4.1.3.5 Mekanika

4.1.3.6 N Spine

4.1.3.7 Paradigm Spine/Viscogliosi Brothers

4.1.3.8 Scient’x/Ideal Medical Products

4.1.3.9 Zimmer Spine/Zimmer

4.1.3.10 Other Dynamic Stabilization Products

4.1.4 Facet and Total Posterior Motion Replacement

4.1.4.1 Archus Orthopedics

4.1.4.2 Facet Solutions

4.1.4.3 Impliant

4.1.4.4 Quantum Orthopedics

4.2 Market Analysis

4.3 Competitive Analysis

Exhibit 4-1:    Anatomic Changes Achieved by Dynamic Stabilization Devices

Exhibit 4-2:    2006, Selected Dynamic Stabilization Products and Indications

Exhibit 4-3:    2006, Selected Interspinous Process Spacers

Exhibit 4-4:    2006, Selected Posterior Dynamic Stabilization Systems

Exhibit 4-5:    2006, Selected Facet and Total Posterior Motion Replacement Products

Exhibit 4-6:    France, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-7:    Germany, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-8:    Italy, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-9:    Spain, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-10:  United Kingdom, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-11:  Europe, Dynamic Stabilization Products, Market Forecast, 2004-2010

Exhibit 4-12:  2005, Dynamic Stabilization Products Market, Share by Supplier

5. VERTEBRAL COMPRESSION FRACTURE PRODUCTS

5.1 Vertebroplasty

5.1.1 ArthoCare

5.1.2 Biomet Europe/Biomet

5.1.3 Orthovita

5.1.4 Stryker

5.2 Kyphoplasty

5.2.1 Disc-O-Tech Medical Technologies

5.2.2 Kyphon

5.3 Other Vertebral Augmentation Systems

5.3.1 ASpine

5.3.2 Spineology

5.4 Market Analysis

5.4.1 Vertebroplasty

5.4.2 Kyphoplasty

5.4.3 Total European Vertebral Compression Fracture Products Market

5.5 Competitive Analysis

5.5.1 Vertebroplasty

5.5.2 Kyphoplasty

Exhibit 5-1:    Comparison of Vertebral Compression Fracture Products

Exhibit 5-2:    Vertebroplasty Indications and Contraindications

Exhibit 5-3:    2006, Selected Vertebroplasty Systems

Exhibit 5-4:    Kyphoplasty, Selected Advantages and Disadvantages

Exhibit 5-5:    2006, Selected Kyphoplasty and Alternative Vertebral Augmentation Systems

Exhibit 5-6:    France, Vertebroplasty Systems, Market Forecast, 2004-2010

Exhibit 5-7:    Germany, Vertebroplasty Systems, Market Forecast, 2004-2010

Exhibit 5-8:    Italy, Vertebroplasty Systems, Market Forecast, 2004-2010

Exhibit 5-9:    Spain, Vertebroplasty Systems, Market Forecast, 2004-2010

Exhibit 5-10:  United Kingdom, Vertebroplasty Systems, Market Forecast, 2004-2010

Exhibit 5-11:  Europe, Vertebroplasty Systems, Market Forecast, by Country, 2004-2010

Exhibit 5-12:  France, Kyphoplasty Systems, Market Forecast, 2004-2010

Exhibit 5-13:  Germany, Kyphoplasty Systems, Market Forecast, 2004-2010

Exhibit 5-14:  Italy, Kyphoplasty Systems, Market Forecast, 2004-2010

Exhibit 5-15:  Spain, Kyphoplasty Systems, Market Forecast, 2004-2010

Exhibit 5-16:  United Kingdom, Kyphoplasty Systems, Market Forecast, 2004-2010

Exhibit 5-17:  Europe, Kyphoplasty Systems, Market Forecast, by Country, 2004-2010

Exhibit 5-18:  Europe, Vertebroplasty and Kyphoplasty Systems, Combined Market Forecast, 2004-2010

Exhibit 5-19:  2005, Vertebroplasty Systems Market, Share by Supplier

Exhibit 5-20:  2005, Kyphoplasty Systems Market, Share by Supplier

6. COMPANY PROFILES

6.1   Abbott Spine, Inc./Abbott Laboratories

6.2   Applied Spine Technologies, Inc.

6.3   ArthroCare Corporation

6.4   Biomet Europe BV/Biomet, Inc.

6.5   DePuy Spine, Inc./Johnson & Johnson

6.6   Dynamic Spine, Inc.

6.7   Globus Medical, Inc.

6.8   Innovative Spinal Technologies, Inc.

6.9   Kyphon, Inc.

6.10 LDR Spine USA, Inc./LDR Médical

6.11 Medtronic Sofamor Danek, Inc./Medtronic, Inc.

6.12 NuVasive, Inc.

6.13 Raymedica, Inc.

6.14 Scient’X SA/Ideal Medical Products

6.15 Spine Wave, Inc.

6.16 St. Francis Medical Technologies, Inc.

6.17 Stryker Spine/Stryker Corporation

6.18 Synthes AG

6.19 Theken Group LLC

6.20 Zimmer Spine, Inc./Zimmer, Inc.

APPENDIX:  COMPANY LISTING

Copyright 2006, Medtech Insight, LLC