Countries covered: United States
Introduction:
The market for minimally invasive (MI) spine technologies in the US has exhibited strong growth for many years. The market is primarily driven by growth in the MI spinal fusion segment, which makes up the majority of revenues, and the facet fixation market. These markets will be driven by the rising patient demand for MI procedures and the growing adoption of MI techniques by surgeons who are looking to expand their practices and provide patients with a less traumatic alternative to open spine procedures. The markets are limited, however, by heightening issues surrounding the reimbursement of spinal fusions by insurance providers in the US; some private payors are developing stricter criteria that must be met before an approval for coverage will be granted for procedures. Both the intradiscal therapy and discography segments will undergo minimal growth due to issues surrounding reimbursement and decelerated growth of the spine market.
Questions Answered in This Report:
- MI spine technologies will be impacted by stricter criteria from insurance providers in the US. How will these criteria impact procedure volumes? What is being done about the situation? Which markets will be the most affected and why?
- Reimbursement issues continue to plague the MI spinal fusion market. Which segments will be impacted and why? How strong will the effects of reimbursement issues be? How is this expected to change over the forecast period?
- Several large spine players will increase their focus in the facet fixation market. Which competitors will expand their presence in this market? Why will these companies devote more attention to this segment? How will this impact overall MI spine technology market growth? What changes will occur in terms of competitive dynamics as a result?
- Challenges with reimbursement will continue to negatively impact intradiscal therapies. Which devices will be affected? How severe is the impact of these reimbursement issues? When is this situation expected to improve?
Scope:
Regions covered: US
Procedure segmentation: Our analysis uses the following breakdown of procedures:
- MI spinal fusions
- Thoracolumbar
- By access instrumentation (mini-open, percutaneous, tubular, and distally expanding)
- By screw type (cannulated and noncannulated)
- By level (1-level, 2-level, and multilevel)
- Cervical
- Trans-sacral
- Interbody devices (IBDs)
- By implant type (nonbone and machined bone)
- By approach (anterior lumbar interbody fusion [ALIF], posterior lumbar interbody fusion [PLIF], transforaminal lumbar interbody fusion [TLIF], and lateral lumbar interbody fusion [LLIF])
- Facet fixation procedures
- By material (titanium and allograft)
- By region of the spine (thoracolumbar and cervical)
- Intradiscal therapies
- Discographies
- By type (generic and brand name)
Market segmentation: Our analysis uses the following breakdown of the market:
- MI spinal fusion market
- Thoracolumbar traditional instrumentation
- By access instrumentation (mini-open, percutaneous, tubular, and distally expanding)
- By screw type (cannulated and noncannulated)
- By level (1-level, 2-level, and multilevel)
- Cervical traditional instrumentation
- Trans-sacral traditional instrumentation
- IBDs
- By approach (ALIF, PLIF, TLIF, and LLIF)
- By implant type (nonbone and machined bone)
- Access instrumentation
- Facet fixation market
- Intradiscal therapy market
- Discography market
- By type (generic and brand name)
Market forecast features: Based on primary research with industry professionals and end-user insights from spine surgeons, we use our proprietary forecasting model to provide an in-depth examination of current and future trends in procedure volumes, unit sales, average selling prices, and market values over a 7-year period (2009-2015).
Competitive analysis: We provide a detailed analysis of the competitive landscape in the market, as well as market shares and qualitative discussions of the leading competitors in each market segment.
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- EXECUTIVE SUMMARY
- METHODOLOGY
- 1.0 US MINIMALLY INVASIVE SPINE TECHNOLOGY INTRODUCTION
- 1.1 Anatomy of the Human Spine
- 1.1.1 Degenerative Spinal Disorders
- 1.1.1.1 Herniated Disc
- 1.1.1.2 Osteoarthritis
- 1.1.1.3 Osteoporosis
- 1.1.1.4 Rheumatoid Arthritis
- 1.1.1.5 Spinal Stenosis
- 1.1.1.6 Spondylosis
- 1.1.1.7 Spondylolisthesis
- 1.1.2 Deformity Spinal Disorders
- 1.1.2.1 Scoliosis
- 1.1.2.2 Lordosis
- 1.1.2.3 Kyphosis
- 1.1.3 Tumor/Trauma Spinal Disorders
- 1.1.4 Treatment Options
- 1.1.4.1 Conservative Treatment
- 1.1.4.2 Surgical Intervention
- 1.1.4.3 Decompression
- 1.1.4.4 Discectomy
- 1.1.4.5 Spinal Arthroplasty
- 1.1.4.6 Spinal Fusion
- 1.1.4.7 Instrumented Spinal Fusion
- 1.2 Thoracolumbar Fusion Devices
- 1.2.1 Implant Design
- 1.2.2 Pedicle Screw Systems
- 1.2.3 Anterior Plating Systems
- 1.2.4 Thoracolumbar Pathology
- 1.2.4.1 Degenerative
- 1.2.4.2 Deformity
- 1.2.4.3 Tumor/Trauma
- 1.3 Cervical Fusion Devices
- 1.3.1 Anterior Cervical Systems
- 1.3.1.1 Constrained Anterior Plates
- 1.3.1.2 Semiconstrained Anterior Plates
- 1.3.1.3 Dynamic Anterior Plates
- 1.3.1.4 Hybrid Anterior Plates
- 1.3.2 Posterior Cervical Systems
- 1.3.2.1 OCT Pedicle Screw Systems
- 1.3.2.2 Traditional Wiring and Cable Systems
- 1.4 Interbody Devices
- 1.4.1 Implant Design
- 1.4.1.1 Threaded Interbody Devices
- 1.4.1.2 Nonthreaded Interbody Devices
- 1.4.2 Implant material
- 1.4.2.1 Nonbone
- 1.4.2.2 Machined Allograft Bone
- 1.4.3 Surgical Approach
- 1.4.3.1 Anterior Lumbar Interbody Fusion
- 1.4.3.2 Posterior Lumbar Interbody Fusion
- 1.4.3.3 Transforaminal Lumbar Interbody Fusion
- 1.4.3.4 Lateral Lumbar Interbody Fusion
- 1.4.3.5 Cervical Interbody Fusion
- 1.5 Facet Fixation
- 1.6 Intradiscal Therapies
- 1.6.1 Intradiscal Electrothermal Therapy
- 1.6.2 Percutaneous Disc Decompression
- 1.6.3 Radiofrequency Disc Decompression
- 1.6.4 Hydrodiscectomy
- 1.6.5 Laser Discectomy
- 1.7 Discography
- 2.0 US MINIMALLY INVASIVE SPINE TECHNOLOGY MARKET
- 2.1 Market Overview
- 2.2 Market Analysis
- 2.2.1 Key Report Updates
- 2.2.2 Procedures
- 2.2.3 Market Forecast
- 2.2.4 Market Drivers and Limiters
- 2.2.4.1 Market Drivers
- 2.2.4.2 Market Limiters
- 2.3 Competitive Analysis
- 2.3.1 Competitive Landscape
- 2.3.2 Market Shares
- 2.3.3 Competitor Discussions (in Alphabetical Order)
- Amedica (through its acquisition of US Spine)
- DePuy Spine
- Medtronic Spinal & Biologics
- minSURG
- NeuroTherm
- Nutech Medical
- NuVasive
- Stryker
- Synthes Spine
- TranS1
- Zimmer Spine
- Other
- 3.0 MINIMALLY INVASIVE SPINAL FUSION MARKET
- 3.1 Market Overview
- 3.2 Market Analysis
- 3.2.1 End-User Insights
- 3.2.2 Market Definitions
- 3.2.2.1 Minimally Invasive Mini-Open Spinal Fusion
- 3.2.2.2 Minimally Invasive Percutaneous Spinal Fusion
- 3.2.2.3 Minimally Invasive Tubular Spinal Fusion
- 3.2.2.4 Minimally Invasive Distally Expanding Spinal Fusion
- 3.2.2.5 Minimally Invasive Hybrid Spinal Fusion
- 3.2.3 Procedures
- 3.2.3.1 Bone Graft Substitutes for Minimally Invasive Spinal Fusions
- 3.2.4 Procedures by Type
- 3.2.4.1 Minimally Invasive Thoracolumbar Spinal Fusions
- Minimally Invasive Thoracolumbar Fusions by Access Instrumentation Type
- Minimally Invasive Mini-Open Systems
- Minimally Invasive Percutaneous Systems
- Minimally Invasive Tubular Systems
- Minimally Invasive Distally Expanding Systems
- Minimally Invasive Thoracolumbar Spinal Fusions by Screw Type
- Minimally Invasive Thoracolumbar Spinal Fusions by Levels per Procedure
- Minimally Invasive Thoracolumbar Spinal Fusions by Pathology
- 3.2.4.2 Minimally Invasive Cervical Spinal Fusions
- 3.2.4.3 Minimally Invasive Trans-Sacral Spinal Fusions
- 3.2.4.4 Minimally Invasive Interbody Device Fusions
- Minimally Invasive Interbody Device Fusions by Approach
- Minimally Invasive Interbody Device Fusions by Implant Type
- 3.2.5 Procedures by Minimally Invasive Access Instrumentation Payment Model
- 3.2.6 Market Forecast
- 3.2.6.1 Minimally Invasive Traditional Instrumentation Market
- Minimally Invasive Thoracolumbar Traditional Instrumentation Market
- Minimally Invasive Mini-Open Traditional Instrumentation Market
- Minimally Invasive Percutaneous Traditional Instrumentation Market
- Minimally Invasive Tubular Traditional Instrumentation Market
- Minimally Invasive Distally Expanding Traditional Instrumentation Market
- Minimally Invasive Cervical Traditional Instrumentation Market
- Minimally Invasive Trans-Sacral Traditional Instrumentation Market
- 3.2.6.2 Minimally Invasive Interbody Device Market
- Minimally Invasive Interbody Device Market by Implant Type
- Minimally Invasive Interbody Device Market by Approach
- 3.2.6.3 Minimally Invasive Spinal Fusion Access Instrumentation Market
- 3.2.7 Market Drivers and Limiters
- 3.2.7.1 Market Drivers
- 3.2.7.2 Market Limiters
- 3.3 Competitive Analysis
- 3.3.1 Competitive Landscape
- 3.3.2 Market Shares
- 3.3.3 Competitor Discussions (in Alphabetical Order)
- DePuy Spine
- Medtronic Spinal & Biologics
- NuVasive
- Stryker
- Synthes Spine
- TranS1
- Zimmer Spine
- 3.3.3.1 Other Competitors
- Aesculap Implant Systems
- Alphatec Spine
- Biomet Spine
- Globus Medical
- Integra Spine
- K2M
- LANX
- Orthofix Spinal Implants
- Pioneer Surgical Technology
- Spinal Elements
- VertiFlex (acquired by Exactech)
- Other
- 3.3.4 Emerging Competitors
- Mazor Surgical Technologies
- VG Innovations
- 3.3.5 Assisting Technologies
- Mazor Surgical Technologies
- SpineGuard
- 4.0 FACET FIXATION MARKET
- 4.1 Market Overview
- 4.2 Market Analysis
- 4.2.1 Procedures
- 4.2.2 Procedures by Material
- 4.2.3 Procedures by Region of the Spine
- 4.2.4 Market Forecast
- 4.2.5 Market Drivers and Limiters
- 4.2.5.1 Market Drivers
- 4.2.5.2 Market Limiters
- 4.3 Competitive Analysis
- 4.3.1 Competitive Landscape
- 4.3.2 Market Shares
- 4.3.3 Competitor Discussions (in Alphabetical Order)
- 4.3.3.1 Smaller Spine Companies
- Amedica (through its acquisition of US Spine)
- Interventional Spine
- minSURG
- Nutech Medical
- SpineFrontier
- TranS1
- VG Innovations
- Other
- 4.3.3.2 Larger Spine Companies (DePuy Spine, Globus Medical, Medtronic Spinal & Biologics,
- NuVasive, and Synthes Spine)
- 5.0 INTRADISCAL THERAPY MARKET
- 5.1 Market Overview
- 5.2 Market Analysis
- 5.2.1 Market Definitions
- 5.2.1.1 Mechanical versus Thermal Intradiscal Therapies
- Intradiscal Electrothermal Therapy
- Percutaneous Disc Decompression
- Radiofrequency Disc Decompression
- Hydrodiscectomy
- Laser Discectomy
- Other Products
- 5.2.2 Procedures
- 5.2.3 Market Forecast
- 5.2.4 Market Drivers and Limiters
- 5.2.4.1 Market Drivers
- 5.2.4.2 Market Limiters
- 5.3 Competitive Analysis
- 5.3.1 Competitive Landscape
- 5.3.2 Market Shares
- 5.3.3 Competitor Discussions (in Alphabetical Order)
- ArthroCare
- Baylis Medical (acquired by Kimberly-Clark)
- Clarus Medical
- HydroCision
- NeuroTherm
- Stryker
- 5.3.3.1 Other Competitors
- elliquence (formerly ellman Innovations)—Disc-FX
- Laurimed—Percutaneous Discectomy System and Discectomy System
- Richard Wolf—Endoscopic Lumbar Spinal Surgery
- Spine View—enSpire
- Various Laser Manufacturers
- 6.0 DISCOGRAPHY MARKET
- 6.1 Market Overview
- 6.2 Market Analysis
- 6.2.1 Market Definition
- 6.2.2 Procedures
- 6.2.2.1 Emerging Technologies
- Cytonics’ Molecular Discography
- 6.2.3 Market Forecast
- 6.2.4 Market Drivers and Limiters
- 6.2.4.1 Market Drivers
- 6.2.4.2 Market Limiters
- 6.3 Competitive Analysis
- 6.3.1 Competitive Landscape
- 6.3.2 Market Shares
- 6.3.3 Competitor Discussions (in Alphabetical Order)
- ArthroCare
- Covidien
- Medtronic Spinal & Biologics
- Merit Medical Systems
- NeuroTherm
- Stryker
- Generic Discography Devices
- APPENDIX A: MRG ACRONYMS AND INITIALISMS
- APPENDIX B: SUPPLEMENTAL FIGURES
- LIST OF FIGURES AND TABLES
- EXECUTIVE SUMMARY
- Figure 1: MI Spine Technology Market, by Segment, US (US$), 2009-2015
- Figure 2: MI Spinal Fusion Market, by Segment, US (US$), 2009-2015
- Figure 3: Facet Fixation Procedures, US, 2009-2015
- Figure 4: Intradiscal Therapy Market, US (US$), 2009-2015
- Figure 5: Discography Market, by Type, as a % of Total, US, 2010 and 2015
- Table 1: Number of Survey Respondents, by Surgical Specialty, US, 2010
- Table 2: Companies Mentioned in This Report
- METHODOLOGY
- Table 3: ICD-9-CM Procedure Codes and Descriptions
- 1.0 US MINIMALLY INVASIVE SPINE TECHNOLOGY INTRODUCTION
- Table 4: Roles of the Spinal Column
- Table 5: Instrumented Spinal Fusion Procedure Classification
- Table 6: Cervical Fusion Device Classification
- Table 7: IBD Classification
- 2.0 US MINIMALLY INVASIVE SPINE TECHNOLOGY MARKET
- Figure 6: MI Spine Procedure Growth, by Segment, US, 2010-2015
- Table 8: Key Report Updates, 2010
- Table 9: MI Spine Procedures, by Segment, US, 2009-2015
- Table 10: MI Spine Technology Market, by Segment, US (US$), 2009-2015
- Table 11: Drivers and Limiters of the MI Spine Technology Market, US
- Table 12: Select MI Spine Technology Clinical Trials, 2010
- Figure 7: Leading Competitors in the MI Spine Technology Market, as a % of Total, US, 2010
- Table 13: Leading Competitors in the MI Spine Technology Market, by Segment, as a % of Total, US, 2010
- 3.0 MINIMALLY INVASIVE SPINAL FUSION MARKET
- Figure 8: MI Spinal Fusions, by Type, US, 2009-2015
- Table 14: MI Spinal Fusion Definitions, US
- Table 15: MI Spinal Fusion Market Definitions, US
- Figure 9: BGS Used in MI Spinal Fusions, by Brand Name, US, 2010
- Table 16: Select MI Spinal Fusion Devices, by Access Instrumentation Type
- Table 17: MI Spinal Fusions, by Approach, US, 2009-2015
- Table 18: MI Spinal Fusions, by Type, US, 2009-2015
- Table 19: MI Thoracolumbar Spinal Fusions, by Access Instrumentation Type, US, 2009-2015
- Table 20: MI Thoracolumbar Spinal Fusions, by Screw Type, US, 2009-2015
- Table 21: MI Thoracolumbar Spinal Fusions, by Levels per Procedure, US, 2009-2015
- Table 22: MI Thoracolumbar Spinal Fusions, by Pathology, as a % of Total, US, 2009-2015
- Table 23: MI Thoracolumbar IBD Fusions, US, 2009-2015
- Table 24: MI Thoracolumbar IBD Fusions, by Approach, US, 2009-2015
- Table 25: MI Thoracolumbar IBD Fusions, by Approach and Implant Type, US, 2009-2015
- Table 26: MI Thoracolumbar IBD Fusion Growth, by Approach and Implant Type, US, 2010-2015
- Table 27: MI Thoracolumbar IBD Fusions, by Approach and Implant Type, as a % of Total, US, 2009- 2015
- Table 28: MI Spinal Fusions, by Type of Access Instrumentation Agreement, US, 2009-2015
- Table 29: MI Spinal Fusion Market, by Segment, US (US$), 2009-2015
- Table 30: MI Traditional Instrumentation Spinal Fusion Market, by Type, US (US$), 2009-2015
- Table 31: MI Traditional Instrumentation Spinal Fusion Market Growth and as a % of Total, by Type, US, 2009-2015
- Table 32: MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market, by Screw Type, US (US$), 2009-2015
- Table 33: MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market, by Access Instrumentation Type, US (US$), 2009-2015
- Table 34: Mini-Open MI Traditional Instrumentation Thoracolumbar Market, by Screw Type, US (US$), 2009-2015
- Table 35: Mini-Open MI Traditional Instrumentation Thoracolumbar Market Growth, by Screw Type, US, 2010-2015
- Table 36: Percutaneous MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market, US (US$), 2009-2015
- Table 37: Tubular MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market, by Screw Type, US (US$), 2009-2015
- Table 38: Tubular MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market Growth, by Screw Type, US, 2010-2015
- Table 39: Distally Expanding MI Traditional Instrumentation Thoracolumbar Spinal Fusion Market, by Screw Type, US (US$), 2009-2015
- Table 40: Distally Expanding MI Traditional Instrumentation Market Growth, by Screw Type, US, 2010- 2015
- Table 41: MI Traditional Instrumentation Cervical Spinal Fusion Market, US (US$), 2009-2015
- Table 42: Trans-Sacral MI Traditional Instrumentation Spinal Fusion Market, US (US$), 2009-2015
- Table 43: MI Thoracolumbar IBD Market, by Implant Type and Approach, US (US$), 2009-2015
- Table 44: MI Thoracolumbar IBD Market Growth, by Implant Type and Approach, US, 2010-2015
- Table 45: MI TLIF Device Market, by Implant Type, US (US$), 2009-2015
- Table 46: MI TLIF Device Market Growth, by Implant Type, US, 2010-2015
- Table 47: MI LLIF Device Market, by Implant Type, US (US$), 2009-2015
- Table 48: MI LLIF Device Market Growth, by Implant Type, US, 2010-2015
- Table 49: MI PLIF Device Market, by Implant Type, US (US$), 2009-2015
- Table 50: MI PLIF Device Market Growth, by Implant Type, US, 2010-2015
- Table 51: MI ALIF Device Market, by Implant Type, US (US$), 2009-2015
- Table 52: MI ALIF Device Market Growth, by Implant Type, US, 2010-2015
- Table 53: MI Spinal Fusion Access Instrumentation Market, US (US$), 2009-2015
- Table 54: Drivers and Limiters of the MI Spinal Fusion Market, US
- Figure 10: Leading Competitors in the MI Spinal Fusion Market, as a % of Total, US, 2010
- Table 55: Leading Competitors in the MI Spinal Fusion Market, as a % of Total, US, 2010
- 4.0 FACET FIXATION MARKET
- Figure 11: Facet Fixation Market, US (US$), 2009-2015
- Table 56: Select Facet Fixation Devices, US
- Table 57: Facet Fixation Procedures, by Material and by Region of the Spine, as a % of Total, US, 2009- 2015
- Table 58: Facet Fixation Market, US (US$), 2009-2015
- Table 59: Drivers and Limiters of the Facet Fixation Market, US
- Figure 12: Leading Competitors in the Facet Fixation Market, as a % of Total, US, 2010
- Table 60: Leading Competitors in the Facet Fixation Market, as a % of Total, US, 2010
- 5.0 INTRADISCAL THERAPY MARKET
- Figure 13: Intradiscal Therapies, US, 2009-2015
- Table 61: Intradiscal Therapy Market, US (US$), 2009-2015
- Table 62: Drivers and Limiters of the Intradiscal Therapy Market, US
- Figure 14: Leading Competitors in the Intradiscal Therapy Market, as a % of Total, US, 2010
- Table 63: Leading Competitors in the Intradiscal Therapy Market, as a % of Total, US, 2010
- 6.0 DISCOGRAPHY MARKET
- Figure 15: Discography Market, by Type, US (US$), 2009-2015
- Table 64: Discography Procedures, by Type, US, 2009-2015
- Table 65: Discography Units, by Type, US, 2009-2015
- Table 66: Discography Market, by Type, US (US$), 2009-2015
- Table 67: Discography Market Growth and as a % of Total, by Type, US, 2009-2015
- Table 68: Drivers and Limiters of the Discography Market, US
- Figure 16: Leading Competitors in the Discography Market, by Type, as a % of Total, US, 2010
- Table 69: Leading Competitors in the Discography Market, by Type, as a % of Total, US, 2010
- APPENDIX A: MRG ACRONYMS AND INITIALISMS
- MRG Acronyms and Initialisms
- APPENDIX B: SUPPLEMENTAL FIGURES
- Figure 17: MI Spine Technology Market, by Segment, US (US$), 2009-2015 (Detailed Format)
- Figure 18: MI Spinal Fusion Market, by Segment, US (US$), 2009-2015 (Detailed Format)
- Figure 19: Facet Fixation Procedures, US, 2009-2015 (Detailed Format)
- Figure 20: Intradiscal Therapy Market, US (US$), 2009-2015 (Detailed Format)
- Figure 21: Discography Market, by Type, as a % of Total, US, 2010 and 2015 (Detailed Format)
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